Long Q Interval Any swimmer's out there who have this?

Bobinator, if I may ask, what was your QTc (QTcorrected) interval? There are people with mild prolongation of the QTc and there are those with significant prolongations. Mild would be in the 460ish range, significant would be 500+ish. When the doc told you that you don't have a syndrome, this is probably what he meant. There are many many causes of prolonged QTc. Medications, electrolyte imbalances, idiopathic (meaning no freaking clue why you have it), and genetic. Some of the genetic causes may be "syndromes" because they are associated with other findings. One in particular is the Jervel and Lange-Nielsen syndrome which is associated with deafness (I'm sure someone asked you about deafness in the family). The reason someone with long QT is at risk is as follows. The QT interval is the time it takes for the heart to repolarize, i.e. get back to its resting electrical state. Normally the ventricles should be completely repolarized before the next depolarization starts (first in the atria, then moves to the ventricles). If it takes a long time for the ventricles to repolarize, then some of the ventricle may be ready to accept a new depolarization and some is not. The electrical impulse then kind of gets shunted along a new and unstable pathway, and suddenly you can get this crazy disorganized depolarization (like a chicken with its head cut off) operating completely independantly of the atria and going super fast. The ventricles can't fill with blood, and their contractions are ineffective. So, regardless of the cause of long QT or whether there is family precedence involved, someone with a long enough QTc is at risk. A couple questions I always use to screen high risk adolescents are: 1. Have you ever passed out during exercise 2. Is there a family history of sudden cardiac death 3. Is there a family history of anyone who died drowning 4. Is there a family history of an unexplained motor vehicle accident death Aside from swimming and intense exercise, collapsing after sudden fear (like hearing a loud BOOM) is always concerning. Not everyone instantly dies from the first episode. Some people are luckly enough to regain the normal rhythm and simpleyt experience light headedness or syncope without death. There are many things that doctors encounter which require risk weighing. Any time I prescribe a medicine I assess the risks and benefits. Any time I order a CT scan I do the same. If there is a chance of death and viable alternatives, I will not take tht risk. Your electrophysicist, while he may think the chance of sudden death is small, will in no way tell you it's OK to swim. He may explain the risks, but the decision is up to you. It would be absolutely stupid of him to assume that risk because as nice a guy as you might be, there is some member of your family and some lawyer that will get together and lick their chops. Thanks for the great information Taruky. I had a lengthly conversation with the people at SADS today. One of the first questions they asked me was my my QTc #. I don't think my electrophysicist gave me this number. They also wanted to know how many ekg's he took or if I had a stress test. I had 1 ekg and he didn't do an exercise stress test. I did have an echo-cardiogram the next day. I am hoping my insurance covers much of the genetic testing. I have 3 kids, my oldest is currently pregnant. I have been a runner, swimmer, triathlete, and all-around workout person since age 11. I've never passed out or had any of the symptoms. I have no known family history of drowning, car accident deaths, or any type of sudden death. This is all very puzzling to me but I feel fortunate to learn of this problem while I have time to do something about it. I have been doing normal swim workouts this week. I was planning to compete in an open-water race saturday but decided against it. If I have to give up racing I can deal with it but I'm really hoping I can continue swimming workouts at least!

Bobinator, if I may ask, what was your QTc (QTcorrected) interval? There are people with mild prolongation of the QTc and there are those with significant prolongations. Mild would be in the 460ish range, significant would be 500+ish. When the doc told you that you don't have a syndrome, this is probably what he meant. There are many many causes of prolonged QTc. Medications, electrolyte imbalances, idiopathic (meaning no freaking clue why you have it), and genetic. Some of the genetic causes may be "syndromes" because they are associated with other findings. One in particular is the Jervel and Lange-Nielsen syndrome which is associated with deafness (I'm sure someone asked you about deafness in the family). The reason someone with long QT is at risk is as follows. The QT interval is the time it takes for the heart to repolarize, i.e. get back to its resting electrical state. Normally the ventricles should be completely repolarized before the next depolarization starts (first in the atria, then moves to the ventricles). If it takes a long time for the ventricles to repolarize, then some of the ventricle may be ready to accept a new depolarization and some is not. The electrical impulse then kind of gets shunted along a new and unstable pathway, and suddenly you can get this crazy disorganized depolarization (like a chicken with its head cut off) operating completely independantly of the atria and going super fast. The ventricles can't fill with blood, and their contractions are ineffective. So, regardless of the cause of long QT or whether there is family precedence involved, someone with a long enough QTc is at risk. A couple questions I always use to screen high risk adolescents are: 1. Have you ever passed out during exercise 2. Is there a family history of sudden cardiac death 3. Is there a family history of anyone who died drowning 4. Is there a family history of an unexplained motor vehicle accident death Aside from swimming and intense exercise, collapsing after sudden fear (like hearing a loud BOOM) is always concerning. Not everyone instantly dies from the first episode. Some people are luckly enough to regain the normal rhythm and simpleyt experience light headedness or syncope without death. There are many things that doctors encounter which require risk weighing. Any time I prescribe a medicine I assess the risks and benefits. Any time I order a CT scan I do the same. If there is a chance of death and viable alternatives, I will not take tht risk. Your electrophysicist, while he may think the chance of sudden death is small, will in no way tell you it's OK to swim. He may explain the risks, but the decision is up to you. It would be absolutely stupid of him to assume that risk because as nice a guy as you might be, there is some member of your family and some lawyer that will get together and lick their chops. Thanks for the great information Taruky. I had a lengthly conversation with the people at SADS today. One of the first questions they asked me was my my QTc #. I don't think my electrophysicist gave me this number. They also wanted to know how many ekg's he took or if I had a stress test. I had 1 ekg and he didn't do an exercise stress test. I did have an echo-cardiogram the next day. I am hoping my insurance covers much of the genetic testing. I have 3 kids, my oldest is currently pregnant. I have been a runner, swimmer, triathlete, and all-around workout person since age 11. I've never passed out or had any of the symptoms. I have no known family history of drowning, car accident deaths, or any type of sudden death. This is all very puzzling to me but I feel fortunate to learn of this problem while I have time to do something about it. I have been doing normal swim workouts this week. I was planning to compete in an open-water race saturday but decided against it. If I have to give up racing I can deal with it but I'm really hoping I can continue swimming workouts at least!