The goal of treating long QT syndrome (LQTS) is to prevent life-threatening, abnormal heart rhythms and fainting spells.
Treatment isn't a cure for the disorder and may not restore a normal QT interval on an EKG (electrocardiogram). However, treatment greatly improves the chances of 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 have SCA
- What treatment you feel most comfortable with
People who have LQTS without symptoms may be advised to:
- Make lifestyle changes that reduce the risk of fainting or SCA. Lifestyle changes may include avoiding certain sports and strenuous exercise, such as swimming, which can cause abnormal heart rhythms.
- Avoid medicines that may trigger abnormal heart rhythms. This may include some medicines used to treat allergies, infections, high blood pressure, high blood cholesterol, depression, and arrhythmias.
- Take medicines such as beta-blockers, which reduce the risk of symptoms by slowing the heart rate.
The type of medicine you take will depend on the type of LQTS you have. For example, doctors usually will prescribe sodium channel blocker medicines only for people who have LQTS 3.
If your doctor thinks you're at increased risk for LQTS complications, he or she may suggest more aggressive treatments (in addition to medicines and lifestyle changes). These treatments may include:
- A surgically implanted device, such as a pacemaker or implantable cardioverter defibrillator (ICD). These devices help control abnormal heart rhythms.
- Surgery on the nerves that regulate your heartbeat.
People at increased risk are those who have fainted or who have had dangerous heart rhythms from their LQTS.
If possible, try to avoid things that can trigger abnormal heart rhythms. For example, people who have LQTS should avoid medicines that lengthen the QT interval or lower potassium blood levels. (For more information, go to "What Causes Long QT Syndrome?")
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.
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.
Pacemakers and ICDs are small devices that help control abnormal heart rhythms. Both devices use electrical currents to prompt the heart to beat normally. Surgeons implant pacemakers and ICDs in the chest or belly with a minor procedure.
The use of these devices is similar in children and adults. However, because children are still growing, other issues may arise. For example, as children grow, they may need to have their devices replaced.
People who are at high risk of death from LQTS sometimes are treated with surgery. During surgery, the nerves that prompt the heart to beat faster in response to physical or emotional stress are cut.
This type of surgery keeps the heart beating at a steady pace and lowers the risk of dangerous heart rhythms in response to stress or exercise.