Long QT Syndrome

Treatment

For acquired LQTS, treatment is aimed at identifying, removing or correcting the element that is causing the LQTS. Usually this element is a medication.

For inherited LQTS, there are three main treatment options. Because certain treatments seem to work better for certain gene mutations, treatment recommendations for LQTS depend on the individual case.

Careful Monitoring

Someone who is age 50 or older when diagnosed and has never had symptoms (fainting, cardiac arrest) may not need treatment. The risk of developing symptoms for the first time after age 50 is not zero, but is probably low enough not to warrant daily medication.

However, it is very important for individuals over age 50 to avoid medications that prolong the QT interval. These medications could trigger a fatal event. In addition, these individuals should pay careful attention to illnesses that could result in low blood potassium (illness in which there is diarrhea or vomiting).

Medications

Beta-blockers work for the majority of people treated for inherited LQTS. These drugs may slow the heart rate and prevent the dangerously fast heartbeats that can come about in times of stress, fear or exertion for people with long QT syndrome. Recent studies suggest that beta-blockers may work better in certain genetic subtypes of LQTS.

Potassium is a mineral in the body that comes from a person's diet. It is important for health of the heart's electrical system. Potassium supplements may improve the heart's recharging system and may be helpful for people with certain forms of long QT syndrome.

View a short video to see how the defibrillator works.

Medical Devices and Surgery

Implantable Cardioverter Defibrillators (ICD). An ICD or ICD/pacemaker combination may be used in the following cases:

• Medications do not work or the individual has unacceptable side effects from the medications.
• There is a strong family history of sudden death.
• The patient's first symptom is a near sudden-death experience.

Such devices are implanted under the skin of the chest through surgery. ICDs automatically sense life-threatening rhythms and deliver electrical therapy or life-saving shock directly to the heart.

Left-sided sympathetic denervation surgery. This surgery is generally reserved for people considered at high risk of sudden death. In this procedure, specific nerves in the chest are surgically cut. These nerves are part of the body's sympathetic nervous system, which controls automatic functions in the body including regulation of heart rhythm.

Lifestyle Changes

In addition to medications or surgery, doctors may recommend lifestyle changes to reduce symptoms. Changes could include avoiding strenuous exercise, reducing loud, startling noises, and staying away from situations that cause strong emotion.

Pediatric Heart Care

Learn more about Mayo's capabilities in treating children with heart conditions.