that occurs in people who have a particular disorder of the heart's electrical activity called long QT syndrome.The QT interval refers to the time between two events on the electrocardiogram—from the beginning of the Q wave to the end of the T wave.
(See also Overview of Abnormal Heart Rhythms Overview of Abnormal Heart Rhythms Abnormal heart rhythms (arrhythmias) are sequences of heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart. Heart disorders are... read more 
and Ventricular Tachycardia Ventricular Tachycardia Ventricular tachycardia is a heart rhythm that originates in the ventricles (lower chambers of the heart) and produces a heart rate of at least 120 beats per minute (the normal heart rate is... read more .)
Some people are born with long QT syndrome. In other people, the disorder is caused by low serum levels of potassium, a very slow heart rhythm, or a drug. Often, drugs used to treat abnormal heart rhythms cause long QT syndrome, but certain antidepressants and certain antiviral and antifungal drugs can also cause it.
People with long QT syndrome may develop torsades de pointes ventricular tachycardia, and sometimes ventricular fibrillation Ventricular Fibrillation Ventricular fibrillation is a potentially fatal, uncoordinated series of very rapid, ineffective contractions of the ventricles (lower chambers of the heart) caused by many chaotic electrical... read more 
. Sometimes, exercise brings on symptoms (see Sudden Cardiac Death in Athletes Sudden Cardiac Death in Athletes An estimated 1 to 3 per 100,000 apparently healthy young athletes develop an abrupt-onset heart rhythm abnormality and die suddenly during exercise. Males are affected up to 10 times more often... read more ).
Symptoms
People with long QT syndrome may have palpitations (awareness of heartbeats) if ventricular tachycardia develops. Torsades de pointes runs of ventricular tachycardia usually stop on their own but frequently recur. People may also feel very light-headed or faint. Ventricular fibrillation causes cardiac arrest Cardiac Arrest and CPR Cardiac arrest is when the heart stops pumping blood and oxygen to the brain and other organs and tissues. Sometimes a person can be revived after cardiac arrest, particularly if treatment is... read more 
and sudden collapse.
Diagnosis
Electrocardiography
Electrocardiography Electrocardiography Electrocardiography (ECG) is a quick, simple, painless procedure in which the heart’s electrical impulses are amplified and recorded. This record, the electrocardiogram (also known as an ECG)... read more 
(ECG) is used to detect long QT syndrome.
Because some forms of long QT syndrome are inherited, people who have a family history of the disorder or have relatives who have died unexpectedly because of a heart problem may be tested for long QT syndrome.
ECG: Reading the Waves
 An electrocardiogram (ECG) represents the electrical current moving through the heart during a heartbeat. The current's movement is divided into parts, and each part is given an alphabetic designation in the ECG. Each heartbeat begins with an impulse from the heart's pacemaker (sinus or sinoatrial node). This impulse activates the upper chambers of the heart (atria). The P wave represents activation of the atria. Next, the electrical current flows down to the lower chambers of the heart (ventricles). The QRS complex represents activation of the ventricles. The ventricles must then undergo an electrical change to get ready for the next heart beat. This electrical activity is called the recovery wave, which is represented by the T wave. Many kinds of abnormalities can often be seen on an ECG. They include a previous heart attack (myocardial infarction), an abnormal heart rhythm (arrhythmia), an inadequate supply of blood and oxygen to the heart (ischemia), and excessive thickening (hypertrophy) of the heart's muscular walls. Certain abnormalities seen on an ECG can also suggest bulges (aneurysms) that develop in weaker areas of the heart's walls. Aneurysms may result from a heart attack. If the rhythm is abnormal (too fast, too slow, or irregular), the ECG may also indicate where in the heart the abnormal rhythm starts. Such information helps doctors begin to determine the cause. |
Treatment
Converting heartbeat to normal rhythm by applying an electric shock (defibrillation)
Preventing further episodes
Defibrillation Restoring normal rhythm Abnormal heart rhythms (arrhythmias) are sequences of heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart. Heart disorders are... read more is needed if ventricular fibrillation develops. Sometimes doctors also give magnesium sulfate.
If a drug is the cause, it is stopped.
People may need to limit their physical activity to prevent a recurrence. They may also need to take beta-blockers (see table Some Drugs Used to Treat Arrhythmias Some Drugs Used to Treat Arrhythmias Abnormal heart rhythms (arrhythmias) are sequences of heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart. Heart disorders are... read more ) or have an artificial pacemaker Artificial pacemakers Abnormal heart rhythms (arrhythmias) are sequences of heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart. Heart disorders are... read more or cardioverter-defibrillator Restoring normal rhythm Abnormal heart rhythms (arrhythmias) are sequences of heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart. Heart disorders are... read more implanted.
More Information
The following is an English-language resource that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.
American Heart Association: Arrhythmia: Information to help people understand their risks of arrhythmias as well as information on diagnosis and treatment
