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Kapa S et al. – Distinguishing pathogenic mutations from rare variants is of critical importance in the interpretation of genetic testing in LQTS. Mutation type, mutation location, and ethnic–specific background rates are critical factors in predicting the pathogenicity of novel mutations. Novel mutations in low–estimated predictive value regions such as the interdomain linker of SCN5A should be viewed as variants of uncertain significance and prompt further investigation to clarify the likelihood of disease causation. However, mutations in regions such as the transmembrane, linker, and pore of KCNQ1 and KCNH2 may be defined confidently as high–probability LQTS–causing mutations. These findings will have implications for other genetic disorders involving mutational analysis.

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