Long QT

[Aerosmith]

I'm a 19 year old male...history of WPW, diagnosis was AV reciprocating tachycardia, Concealed anteroseptal pathway.  Sucessful ablation..also have MVP, with regugatation/insuffiency.  

After this ablation I was seeing a diffrent electrophysiologist, and he noted a couple prolonged QT intervals for being me being a male....They were listed at about
rate 89, QTc 434
rate 81, QTc, 425

We discussed LQTS and really didn't go any farther...he issued a king of hearts monitor to record my orhtostatic tachycardia..

these were minor 'borderline normal' QT intervals for males, and could be normal I knew... That EP doc relocated, and I was with my old one... yesterday during my first routine EKG since then it was revealed that I had a rate of 53, and a QT od 552, QTc 518..I am studying int he medical field and do know how to read ECG's...and it was not a error, It was clearly visible that I had a prolonged QT interval.  The power went out, and I had to leave ot the lobby and reschedule because things got a little hectic.  The EKG did not get reviewed but I asked for it and it was given to me..never reviewed or looked at.  I have multifocal PVC's and runs of PVC's..even tonight I had a very symptomatic run of PVC's.  Back when I was wearing the King of heart's monitor, I would go to sleep and wake up to find it had recorded in my sleep rates jumping up near 250 for very, very brief amounts of times, I was asymptomatic to those.  I do not have anxiety, but am curious over the QT interval being so long. What's your take on all this..including the monitor???

[sabrina]

Hi,

My heart also races but they havent found out what kind of arrhythmia this is and i am worried that I have Long QT sydrome too.
My ecgs:

88bpm Qtc was 415
107bpm QTc was 435
102bpm Qtc was 518 (with non-specific t-wave abnormality)

Does this sound like LQTS? Which forms of LQTS are more dangerous? ANd what are the symptoms of the dangerous forms??
HOw are they diagnosed?

thnks

[CCF-M.D.-CRC]

Dear Aerosmith,

Long QT syndrome (LQTS) is a genetic abnormality of cardiac electrolyte channels that results in a prolongation of the QT interval on the surface ECG.  There are several different types of LQTS and they may be inherited or denovo.  Some types of LQTS are associated with an increased risk of sudden death.

Diagnosis of LQTS is from the ECG and patient history.  The majority of individuals with prolonged QT intervals on their ECG do not have LQTS but are mearly at the outer ranges of normal. The pattern and morphology of the T waves is also important in making the diagnosis.  Other causes of prolonged QT interval such as medications must be ruled-out. Genetic markers are also being developed to screen for LQTS.   If there is a family history of sudden unexplained death at an early age then the patient is probably at higher risk of sudden death.  Treatment can be medical with beta-blockers or surgical with an implantable cardiac defibrillator.  

Knowing the type of rhythm you were having during your sleep would be helpful in determining what the best treatment is for you.  If it was a SVT (coming from the top chambers) a repeat ablation may be needed.  If it was ventricular tachycardia then more investigation would need to be given to the LQTS question.