Treatment of prolonged QT syndrome

All patients, regardless of whether the syndrome is congenital or acquired, are prescribed beta blockers. The exception is those groups of patients in whom arrhythmia occurs at rest. Not only will they not respond to therapy, but they will also fall into the risk zone due to a slowing of the heart rhythm. Sodium channel blockers are also prescribed. Regular intake of magnesium and potassium is an addition to the main treatment of the pathology. In the case of the QT syndrome provoked by taking medications, treatment measures are aimed at their cancellation. In difficult and life-threatening situations, resuscitation measures are used.

Drug treatment

There are three generations of beta-adrenaline receptor blockers:

• the first - non-selective (anaprilin, pindolol, sotalol);
• the second - cardioselective (bisoprolol, atenolol, betaxolol);
• the third - with an additional vasodilating effect (labetalol, carvedilol, nebivolol).

Anaprilin is a non-selective adrenoreceptor, 10 and 40 mg tablets, there is also an injection form. The drug is taken 10 minutes or half an hour before meals, washed down with a large volume of water. Start with a small dose and, if well tolerated, increase (from 10 mg per day to 100 mg, and with a weak effect, up to 200-300 mg), dividing into 4 doses. Side effects can be expressed in the form of nausea, vomiting, dizziness, decreased blood pressure, bradycardia. Contraindicated in bronchial asthma, Prinzmetal angina, diabetes mellitus with ketoacidosis, allergies to components.

Bisoprolol - tablets, has the property of reducing blood pressure, is a preventive measure against angina attacks. The dose is determined individually, the average daily dose is 5-10 mg. It is recommended to take once in the morning on an empty stomach or during meals. Possible side effects: insomnia, headaches, decreased heart rate. Contraindicated in case of peripheral circulatory disorders, certain cardiac pathologies, individual intolerance.

Labetalol - tablets of 100 and 200 mg, injection solution (5 ml or 50 mg in an ampoule). Blocks not only beta-blockers, but also alpha, which provides a lasting pressure-lowering effect. Taken three times a day at a dose of 0.1 g. In hypertensive crises, 2 ml of 1% solution is administered intravenously (slowly). The drug can cause a feeling of fatigue, headache, constipation. Contraindications include heart failure; patients with bronchial asthma should take it with caution.

Sodium channel blockers used in long QT syndrome include flecainide and mexiletine.

Flecainide is an antiarrhythmic drug, available in tablets. Each heart disease has its own therapeutic dose. On average, it ranges from 50 mg to 100 mg, but the maximum daily dose is 300-400 mg. For children, the dose is calculated based on body surface area: 50 mg per m ². It is not prescribed to people who have had a myocardial infarction, with heart defects, unstable ventricular tachycardia, heart rate slowing below 50, during pregnancy and breastfeeding. It can cause visual impairment, asthenia, shortness of breath, dry mouth, bronchospasm.

Vitamins

The following vitamins are necessary for the proper functioning of the heart:

• C - reduces cholesterol levels, strengthens the walls of the heart. In addition to ascorbic acid, sold in pharmacies, it is necessary to include citrus fruits, sorrel, currants in the diet, make rosehip decoctions;
• A (or retinol) - improves metabolism in heart tissue. Contained in all green, orange, red, yellow products. Most of it is in carrots, sweet peppers, tomatoes, apricots;
• E (or tocopherol) - keeps the heart muscle in good shape, helps prevent the development of arrhythmia. Vegetable oils, nuts, margarine, many cereals (buckwheat, wheat, oatmeal), fish, liver - those products that should be on our table;
• R (rutin) - belongs to the group of flavonoids known for their rejuvenating properties. It is not produced by the body. Its role is to strengthen the walls of capillaries, reduce heart rate and blood pressure. It enters the body with citrus fruits, grapes, cherries, red bell peppers, garlic, lettuce, tomatoes, cabbage;
• F (polyunsaturated fatty acids) — prevents the formation of sclerotic plaques on the walls of blood vessels. Its sources are vegetable oils from wheat germ, flax seeds, sunflower, soybeans, as well as almonds, avocados, brown rice, nuts.

The most important thing is to ensure a balance of essential vitamins and microelements, in which, despite genetic predispositions, the heart will receive everything it needs to function.

Physiotherapy treatment

Physiotherapeutic treatment of long QT syndrome may include electropulse therapy or electrocardiostimulation. This method is temporary and consists of placing 2 electrodes on the patient's chest wall, through which an electric current of up to 100 J is passed. It is used if drug therapy does not bring the expected effect.

Folk remedies

You shouldn't rely on folk remedies for serious heart problems, but you can reduce tachycardia and arrhythmia, pain and discomfort in the chest area, and calm down after stressful situations and physical exertion with the help of the following recipes:

• mix a glass of honey, juice of 4 lemons, crushed almonds (up to 20 pcs.), add a teaspoon of pharmacy valerian and hawthorn. Take a tablespoon daily in the morning on an empty stomach;
• compresses on the soles of the feet with baked onions, applied at night, will help with arrhythmia;
• Put a liter of water on the fire for a quarter of an hour with the addition of 2 chopped onions, 5 heads of garlic, a spoonful of rowan berries, then add a teaspoon of dill seeds, marsh cudweed, parsley and boil for another 5 minutes. Cool, drink 2 tablespoons before meals 3-4 times a day. After a month, you need to take a two-week break.

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Herbal treatment

The following herbs are used in cardiology:

• Adonis vernalis (contains up to 0.15% cardiac glycosides);
• Murraya paniculata is a houseplant in our country, and an evergreen shrub in the tropical climate zone. Both flowers and leaves have medicinal properties similar to the well-known Chinese magnolia vine: tea or decoction from them lowers blood pressure, normalizes heart rhythm. It is recommended to keep the plant in the bedroom of a heart patient, because its essential oils promote good sleep, reduce attacks of angina;
• celandine - rich in cardiac glycosides;
• motherwort, hawthorn, and valerian, known to everyone for their cardiological properties.

Homeopathy

In combination with therapeutic measures for the treatment of cardiac pathologies accompanied by prolongation of the QT interval, homeopathic remedies are used.

Accardium - granules, 20g each, containing metallic gold, mountain arnica, and anamirta coculus. Due to the properties of the components, the drug treats and prevents cardiovascular diseases, reduces blood pressure and cholesterol. Granules (10 pieces) are placed under the tongue 30 minutes before meals or an hour after until completely dissolved 2 times a day. The course of treatment is 3 weeks. No side effects have been identified, there are no contraindications. Dilute by half an hour with beta- and adrenoblockers.

Angio-Injel is a complex injection solution indicated for ischemic heart disease, arterial hypertension, neurocirculatory dystonia, and post-infectious myocarditis. It is used from the age of two. A single dose for children aged 2-3 is 0.3 ml, 3-6 years - 0.6 ml, 6-12 years - 0.7 ml, and after 12 years - 1.1 ml. The dose is taken once a day for two or three days, then 1-3 times a week. The route of administration is oral, subcutaneous, intravenous, and intramuscular. For oral administration, the liquid is diluted in 5-10 ml of water and held in the mouth for a while during swallowing. The duration of treatment is 2-5 weeks. Side effects are possible with increased hypersensitivity to the components of the product. People with thyroid disease should take it with caution. It is compatible with other drugs.

Aurocard - drops for oral use, prescribed in case of heaviness in the heart area, mild to moderate heart failure, angina with shortness of breath. Take 20 drops three times a day, can provoke nausea, vomiting, heart rhythm disturbances. If such symptoms occur, stop taking the drug. Contraindicated in case of allergy to the components, treatment with cardiac glycosides, potassium deficiency in the body.

Cardiolin is a drop containing medicinal herbs with cardioprotective action. No studies have been conducted on its effect on children. The recommended dose for adults is 20-30 drops 2-3 times a day for 3-4 weeks. Not prescribed to pregnant women or children. Not compatible with alcohol or medications containing it. Taking Cardiolin may cause nausea, constipation or diarrhea, headache, drowsiness.

Surgical treatment

Surgical treatment is used in cases of severe life-threatening arrhythmia. It consists of implanting a pacemaker, which allows normalizing the heart rhythm. The device itself is sewn into the large pectoral muscle on the left side, and its electrodes are carried through the venous bed into the heart chambers, where they are fixed. A special device - a programmer - adjusts the implant. If the pacemaker batteries are weakened, they can be replaced during a simple manipulation.