How Is Long QT Syndrome Treated?

Goals of Treatment

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

Specific Types of Treatment

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

• What type of LQTS you have
• How likely it is that you will faint or that your heart will suddenly stop beating
• What treatment you feel most comfortable taking

People who have a lower risk of complications from LQTS may want to try less aggressive treatments, such as making lifestyle changes (avoiding situations that trigger irregular heartbeats) or taking medicines. The type of LQTS you have will determine which medicines you take to avoid abnormal heart rhythms. For example, doctors will usually only prescribe sodium channel blocker medicines for people with LQTS 3.

If your doctor thinks you're at higher risk for complications from your LQTS, he or she may recommend 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)) that helps regulate your heartbeat
• Surgery on the nerves that regulate your heartbeat

Patients 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 irregular heartbeat. Many people with LQTS also benefit from adding more potassium to their diets. They should check with their doctor about eating more potassium-rich foods, such as bananas, or taking potassium supplements daily.

People with LQTS also should avoid medicines that lengthen the QT interval or lower potassium blood levels. (See "What Causes Long QT Syndrome?")

Medicines

Beta blocker heart medicines prevent the heart from beating faster in response to physical or emotional stress. Most people with LQTS are treated with beta blockers. Doctors may suggest that people with LQTS 3 take sodium channel blocker medicines, such as mexiletine. These make sodium ion channels less active.

Pacemaker or Implantable Cardioverter Defibrillator

These are surgically implanted devices that monitor the heart rhythm and 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 at high risk of death from LQTS are sometimes treated with surgery in which the nerves that prompt the heart to beat faster in response to physical or emotional stress are cut. This helps to keep the heart beating at a steady pace and decreases the chances of developing dangerous heart rhythms in response to stress or exercise.