How Is Long QT Syndrome Treated?

The goal of treating long QT syndrome (LQTS) is to prevent life-threatening, abnormal heartbeats and fainting spells. Treatment isn't a cure for this condition and may not restore a normal QT interval on an EKG. But treatment does greatly improve survival.

Specific Types of Treatment

Your doctor will recommend the best treatment for you based on:

• Whether you've had symptoms, such as fainting or sudden cardiac arrest (SCA)
• What type of LQTS you have
• How likely it is that you'll faint or that your heart will suddenly stop beating
• What treatment you feel most comfortable taking

People who have LQTS but no symptoms may be advised to:

• Make lifestyle changes that reduce the risk of fainting or SCA. These may include avoiding competitive sports and strenuous exercise, such as swimming, which can cause abnormal heartbeats.
• Avoid medicines that may trigger symptoms. This may include some medicines used to treat allergies, infections, high blood pressure, high blood cholesterol, and depression.
• Take medicines, such as beta-blockers, which reduce the risk of symptoms by slowing your heart rate.

The type of LQTS you have will determine which medicines you take to avoid abnormal heart rhythms. For example, doctors usually only will prescribe sodium channel blocker medicines for people who have LQTS 3.

If your doctor thinks you're at higher risk for LQTS complications, he or she may suggest other more aggressive treatments (in addition to medicines and lifestyle changes). Such aggressive treatments include:

• A surgically implanted device, such as a pacemaker or implantable cardioverter defibrillator (ICD). These devices help regulate your heartbeat.
• Surgery on the nerves that regulate your heartbeat.

People at higher risk are those who have fainted or who have developed dangerous heart rhythms from their LQTS in the past.

Lifestyle Changes

If you have LQTS, you should try to avoid, if possible, the specific triggers you have for an abnormal heartbeat. Many people who have LQTS also benefit from adding more potassium to their diets.

Check with your doctor about eating more potassium-rich foods, such as bananas, or taking potassium supplements daily.

People who have LQTS also should avoid medicines that lengthen the QT interval or lower potassium blood levels. (For more information, go to "What Causes Long QT Syndrome?")

Medicines

Beta blockers are medicines that prevent the heart from beating faster in response to physical or emotional stress. Most people who have LQTS are treated with beta blockers.

Doctors may suggest that people who have LQTS 3 take sodium channel blockers, such as mexiletine. These medicines make sodium ion channels less active.

Pacemaker or Implantable Cardioverter Defibrillator

These surgically implanted devices monitor the heart rhythm. They deliver electrical currents to the heart when they detect an abnormal heart rhythm. Surgeons implant pacemakers and ICDs in the chest or belly with a minor procedure.

Surgery

People who are at high risk of death from LQTS are sometimes treated with surgery. During this surgery, the nerves that prompt the heart to beat faster in response to physical or emotional stress are cut.

This helps keep the heart beating at a steady pace and decreases the chances of developing dangerous heart rhythms in response to stress or exercise.