Can Acquired Long QT Go Away?
Given the complexity of acquired long QT syndrome and the importance of establishing a correct diagnosis and treatment plan, people with suspected acquired long QT syndrome should be referred to a center of excellence, dedicated to families with this hereditary heart disease, which despite being life-threatening, is also treatable. No case of spontaneous remission has been described.
Acquired long QT syndrome is a cardiovascular condition characterized by abnormal heart rhythms normally diagnosed symptoms experienced by the patient and an abnormal 12 lead electrocardiogram, a family history of this condition. The acquired long QT syndrome, once diagnosed, can usually be treated well.
The heart causes blood to circulate through the body with each beat. The contraction and relaxation of the cardiac chambers is what causes the blood to flow through the entire body. This process which occurs with every heartbeat is controlled by electrical impulses which are produced after each beat. This process is repeated after every beat.
What happens in acquired Long QT Syndrome is that it takes longer for the electrical impulses to get activated and control the process of contraction and relaxation of the cardiac chambers. This abnormality can be easily detected with an electrocardiogram but since people do not undergo regular ECGs diagnosis is often delayed unless the patient has visible symptoms or there is a family history of this condition.
Inherited form of long QT interval syndrome can be observed in approximately 1 of every 1500 people. However, those statistics probably underestimate it because there are many cases the condition remains undiagnosed due to lack of symptoms. In addition, there have been cases where individuals have suffered a sudden cardiac arrest and are not able to survive resulting in unexplained drowning in water or car accidents. All of these can result due to Long QT Syndrome.
One of the most prominent symptoms of acquired long QT syndrome is syncopal spells. These spells are triggered due to irregular heartbeat normally while exercising or doing any other physical activity and also as a result of emotional outbursts. If the heartbeat remains irregular and fast for a long period of time the brain may be deprived of oxygenated blood causing seizures. The individual may experience a sudden cardiac arrest if the heartbeat still does not return back to normal.
Currently, the acquired long QT syndrome is not included in the general detections. In majority of cases, it is diagnosed through an ECG done after an individual experiences a syncopal event without any warning. As genetics play a crucial role in acquired long QT syndrome, some people are diagnosed when a relative gets diagnosed with this disorder. In other cases, however, relatives in the first degree of consanguinity like siblings and children undergo tests for long QT syndrome when sudden and unexpected death occurs within the family. Genetic testing needs to be mandatory when evaluating acquired long QT syndrome.
Once diagnosis of long QT syndrome is made, treatment begins normally with a beta-blocker. Other medications for irregular heartbeat may also be used in combination with the beta-blockers.
If medications are not able to control the disorder, then a surgical procedure called left cardiac sympathetic denervation is recommended. It is a minimally invasive procedure in which nerves from the left side of the spine, which release a substance called noradrenaline in the heart muscles, are removed. Surgery significantly reduces the risk of syncopal spells, seizures, or sudden death due to a prolonged QT interval.
Sometimes, despite medications or surgery, an individual with acquired long QT syndrome may still be at significantly high risk of sudden death. In such cases, a defibrillator is implanted in the chest. That device is capable of stopping a life-threatening heart rate because it administers an electrical shock so that the heart rate returns to normal.
The treatment of the acquired long QT syndrome is based on the risk assessment of the patient. In majority of the cases, the long QT syndrome, once identified, can be successfully treated such that the patient can lead a normal life irrespective of the diagnosis.