What is Long QT Syndrome?
Long QT Syndrome (LQTS) is a condition that causes fast, chaotic heartbeats as a result of an abnormal electrical circuit. The condition is characterized by a long QT interval on an electrocardiogram (ECG). This interval represents how much time it takes for the heart’s electrical system to send a signal through the ventricles, causing the heart to contract and then retract. With LQTS, there is a delay in the amount of time it takes for the heart to contract and recharge, increasing the risk of dangerous ventricular tachycardia. LQTS is rare but can be life-threatening if left untreated.
What Causes Long QT Syndrome?
Long QT syndrome can develop due to certain medication, but most cases of LQTS are congenital. Congenital LQTS is inherited at birth, caused by an abnormality in the gene code for the ion channels, resulting in slow recovery after each heartbeat. Those at a higher risk for LQTS are:
- Children who are born deaf
- A family or personal history of syncope (fainting)
- A family history of unexplained sudden cardiac death
- A family history of LQTS
What are the Symptoms of Long QT Syndrome?
Long QT syndrome prevents the heart from effectively pumping blood to the rest of the body. Symptoms associated with LQTS are due to this severe arrhythmia and can result in:
- Syncope (fainting)
- Seizures
- Sudden death
Symptoms of LQTS are most likely to occur during exercise, emotional distress or excitement, during sleep, or upon waking suddenly. Some with LQTS never experience symptoms and are diagnosed through a routine ECG. If symptoms do occur, they usually begin in the early teen years.
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Types of Long QT Syndrome
There are two primary forms of Long QT syndrome, each with different underlying causes but the same potential to disrupt the heart’s electrical activity. Proper diagnosing long QT syndrome begins with a thorough evaluation of a patient’s medical history, symptoms, family history, and electrocardiogram (ECG). During testing, healthcare providers measure the normal QT interval and compare it to the patient’s results to identify any abnormalities. A confirmed long QT syndrome diagnosis helps guide treatment and reduce the risk of serious heart rhythm complications.
Acquired Long QT Syndrome
Acquired Long QT syndrome develops after birth and is most commonly caused by certain medications, electrolyte imbalances, or underlying medical conditions. Many cases are linked to QT prolonging drugs, including some antibiotics, antidepressants, and antiarrhythmic medications. This form of drug induced QT prolongation is often reversible once the underlying cause is identified and addressed. Because QT interval prolongation can increase the risk of dangerous heart rhythms, early recognition and prompt treatment are important to prevent complications such as cardiac arrest.
Congenital Long QT Syndrome
Congenital Long QT syndrome is an inherited condition caused by genetic mutations that affect the electrical channels responsible for regulating the heartbeat. Individuals born with this disorder have a greater risk of developing prolonged QT interval, which may trigger abnormal heart rhythms during exercise, emotional stress, or even while sleeping. Careful monitoring and treatment can help reduce the risk of QT prolongation and improve long-term heart health. Early diagnosis is especially important for family members who may also carry the inherited condition.
How is Long QT Syndrome Treated?
If you experience symptoms of LQTS or have a family history of the condition, you should seek treatment. To diagnose LQTS, Dr. Beshai will perform an ECG to detect irregular activity in the heart’s electrical system. He will likely perform a stress test as well to determine how the heart responds to exercise. A Holter monitor can also be used to record the heart’s electrical activity over a longer period of time, typically 24-48 hours. This will show Dr. Beshai if there are abnormalities in the heart’s rhythm.
Once LQTS is detected, Dr. Beshai will develop a treatment plan to manage the condition and prevent complications related to a severe arrhythmia. Most patients who are diagnosed with LQTS are given a beta-blocker, even if they do not experience symptoms. Other medications may be prescribed to shorten the length of the QT interval. You will be asked to avoid certain medications and always check with your doctor before taking anything, even over-the-counter medications. In some cases, further treatment is needed and Dr. Beshai may use an implantable cardioverter defibrillator (ICD). An ICD is a small device attached to the heart and can shock the heart when life-threatening arrhythmias occur, preventing sudden death.
Scheduling Your Long QT Syndrome Treatment Appointment
Long QT syndrome can be life-threatening, and treatment should be sought even if you do not experience symptoms yet. Dr. Beshai can provide the right course of treatment to ensure complications of LQTS do not occur. If you have a family history of LQTS and believe you could be at risk, contact our office and schedule your appointment at the Heart Rhythm Institute of Arizona.
The Heart Institute of Arizona has a wide array of services that come with our premium care. From in-office dianostics and treatable conditions, to hospital based procedures, we’ve got your heart covered.
Dr. Beshai is a board-certified electrophysiologist internationally renowned and respected for his expertise and research. Having published in major medical journals and travelled all over the world to present research, he is dedicated to providing innovative, state-of-the-art care to his patients.