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. |