There is no medical treatment specifically for LGL syndrome. Interventions are directed at identifying and resolving the cause of the tachycardia. When episodes produce symptoms, hospitalization is indicated, with the priority being to gain control of the patient’s ventricular heart rate. Immediate measures include Valsalva maneuver and/or carotid massage if there are no carotid bruits. Failure of these measures to interrupt the tachydysrhythmia may indicate the need to administer adenosine during continuous electrocardiography monitoring and recording. Treatment of the episodic paroxysmal supraventricular tachycardia may be undertaken on an outpatient basis. Pharmacologic treatment options include β-blocking medications, calcium channel–blocking medications, and digoxin. In the most extreme conditions/scenarios, radiofrequency ablation of either the AV node or bundle of His may be indicated. After successful pathway ablation, a pacemaker must be implanted.

Any complications are attributable to the underlying condition.

Frequently the patient with LGL presents for accessory pathway ablation. As such, pharmacologic interventions are usually stopped to aid in inducing a tachydysrhythmia. The patient is pharmacologically unprotected. Anxiolysis is important to lessen the chance of inciting a tachydysrhythmia in relatively uncontrolled surroundings, such as the patient’s room, the elevator, and/or the anesthesia holding room. Relatively heavy premedication is most helpful in achieving the desired degree of anxiolysis. If a tachydysrhythmia occurs, it may be controlled using very short-acting agents, such as esmolol or adenosine.