Treatment

Treatment for long QT syndrome involves lifestyle changes, medications, and possibly surgery or other procedures.

The goal of treatment is to prevent erratic heartbeats and sudden death. Your doctor will discuss with you the most appropriate treatment options based on your symptoms and your type of long QT syndrome. Your doctor might suggest treatment even if you don't often have signs or symptoms.

If you have drug-induced long QT syndrome, stopping the medication causing your symptoms may be all that is needed to treat the condition. Your doctor can tell you how to safely do so.

For other cases of acquired long QT syndrome, treating the underlying condition is necessary. Treatment varies but may include magnesium or other fluids given by IV to correct electrolyte imbalances.

Medications

Medications won't cure long QT syndrome, but they can help protect against possible life-threatening heart rhythm changes.

Medications used to treat long QT syndrome may include:

• Beta blockers. These heart drugs are standard therapy for most patients with long QT syndrome. They slow the heart rate and make long QT episodes less likely. Beta blockers used to treat long QT syndrome include nadolol (Corgard) and propranolol (Inderal LA, InnoPran XL).
• Mexiletine. Taking this heart rhythm drug in combination with a beta blocker might help shorten the QT interval and reduce your risk of fainting, seizure or sudden death.

Always take the medications your doctor prescribes as directed.

Surgery or other procedures

Depending on your symptoms, your doctor might consider other long QT syndrome treatments for you, including:

• Left cardiac sympathetic denervation (LCSD) surgery. In this procedure, surgeons remove specific nerves along the left side of your spine in your chest. These nerves are part of the body's sympathetic nervous system, which helps control your heart rhythm.

  LCSD is generally reserved for people with long QT and persistent heart rhythm problems who are at high risk of symptoms and cannot take or tolerate beta blockers. It doesn't cure long QT syndrome, but it does help reduce the risk of sudden death.

• Implantable cardioverter-defibrillator (ICD). An ICD is implanted under the skin of your chest and continuously monitors your heartbeat. It can stop a potentially life-threatening arrhythmia. When an ICD detects an abnormal heart rhythm, it delivers electrical shocks to reset the heart back to normal.

  Most people with long QT syndrome do not need an ICD. However, the procedure may be done in certain athletes to allow return to competitive sports. The decision to implant an ICD, especially in children, needs to be carefully considered. Implanting an ICD is a major procedure and can result in inappropriate shocks and other complications.