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

Hi Amy!!! Thanks for your response. I am hoping to find out today if my insurance will take care of the genetic testing. I figure it will since it's a pretty great policy. Your words are encouraging! I already figured I needed to make sure my potassium levels are good due to the Q rhythm being the part that is fired by potassium. What do you do to insure your potassium level is where it should be? I've googles a list of potassium rich foods I intend to start eating regularly (actually I already eat most of them regularly) I am sorry you had to go through this. I had no idea. I'm going to keep in touch with you about this. If I get annoying to you just tell me so and I'll back off. Thanks, Robin

Is there a history of sudden death in your family? If not, your individual risk may be less. I agree with genetic testing. The concern is that lethal arrhythmias can develop during strenuous exercise in patients with long QT syndrome. Hi Gull, No member of my family has died from a sudden cardiac event. I am an only child and both my parents died from lung cancer. (they both smoked) My dad was an extremely successful high school and college athlete, well at least until he enlisted in WWII and became a Ranger. I am hoping my insurance pays for the genetic testing and I am getting an echo-cardigram in about an hour. I really don't want to try the beta blockers, the side-effects sound miserable and make me want to cry. I am planning to swim again today, easy sets on moderate to easy intervals. I keep telling myself "nothing is different from last week" Do you think sprinting would be worse for me than distance? I rarely do a proper sprint, I'm not wired for it. I really like the 500 / 800 / 1500 type stuff. I guess I don't need to race, or I could just do it purely for the social aspect and take it easy. I'm not that fast anyway.

I won't be annoyed :) See if your electrophysiologist will work with your insurance company to get them to cover you if you have any issues. Mine was helpful with that. I've been eating bananas and dried apricots fairly regularly since this all started. My doctor told me to drink Gatorade when I saw him last. I do that sometimes but mostly try to eat fruits and veggies to get all those nutrients. Are you like me in that you have no personal or family history of any kind of fainting or sudden death? This diagnosis just completely struck me out of nowhere. That's part of what made it so creepy. That, and I have three kids who I was worried I might have passed some hideous gene on to. Jim--I read the Dana Vollmer article and have to say that I kind of agree with the last statement where Dana said she'd rather die swimming than doing nothing. However, when you factor in your kids, that makes the decision process that much more difficult. In my case, the Long QT intervals seemed to only occur at rest. So, really, not exercising seemed more dangerous for me!

My recollection - Dana did not swim year-round until age 11 and had USAS AAAA cuts within a few months. She made her Sr National cuts age 12. Her coaches did not have her training 2-a-days until later after she developed a better training base. While she began swimming on a recreational summer league, she did have solid coaching. It seemed like her parents had the right touch, involved but letting it be "her" sport. Her innate abilities were recognized immediately - she just made swimming fast look so easy. She also has the kind of competitive fire and mental focus you can't coach into somebody. I will always enjoy hearing about her accomplishments.

BTW, I was put on a low dose Beta Blocker (Metoprolol) while my genetic testing results weren't known. The doctor seemed to be telling me he thought my QT issues wouldn't be affected by the Beta Blocker but to take it anyway. He had me start with half a 25mg pill--and I just stayed on that. It did feel odd at first (though it's hard to say how much of that was me just being a little freaked out). I thought it would really affect me but I got used to it pretty quick. Didn't really seem to affect my swimming all that much--but maybe because I was on such a low dose. The doctor ended up taking me off the meds once my test results were back. Good luck at the doctor this morning :)

And which genetic sub-type is more at risk? I'm guessing it's women? Actually I was referring to the specific genes that have been linked to long QT syndrome.

I have a general question that I am hoping Gull can answer. (By the way, Gull, great 800 m at your recent championships.) The question is this: Are serious adult athletes the same, physiologically speaking, as your typical overweight sedentary Americans with heart and other issues? Two times I have been given very worrisome diagnoses. The first was when I was diagnosed with anemia. The second was when I was diagnosed with first degree heart block. Both times, perhaps due to my psychiatric frailty, which alternates between a "worried well" mentality to outright clinical hypochondriasis, these conditions threw me into a major nutty (the layman's term for health-diagnosis-related spasms of anxiety and depression.) However, in both cases, further investigation revealed that conditions that can be highly worrisome in the typical American might not be so bad in me; in fact, they might actually represent positive adaptations to exercise. The anemia, for instance, was most likely so-called sports anemia, a pseudo anemia that results from increased blood plasma diluting the blood concentration, making it look like I had a deficiency of RBCs, etc., when in fact they were only diluted. As far as the heart block goes, this, too, appears to be related to being in good shape and is not uncommon in trained endurance athletes. My resting heart rate is as low as 34 bpm. As one doctor explained it, when your heart beats that slowly, some intervals have to become elongated, and in my case it was the one associated with the so-called first degree block. I guess my question is this: is it possible that Amy, Robin, and Dana all suffer a "problem" that may not be problematic at all, but rather represents some as yet unelucidated adaptation to loads of hard training over many years? Maybe this is magical thinking on my part, but I sometimes wonder if medical science's fast-evolving ability to diagnose anomalies may identify "disorders" that are best left un-revealed. Had Amy and Bob never learned about their long q intervals, isn't it more likely than not they would have been able to exercise, as they always had, long into their dotage without any problems? Are there areas where ignorance really is bliss?

Are there areas where ignorance really is bliss? Great questions, Jim. I've wondered the same thing. I didn't know what I was going to do if I tested positive for a known QT issue. Do you tell your kids that they might suddenly drop dead if they exercise or do anything adventurous? Or do you let them live life? Especially when you and every one of your family members have lived symptom-free for years and years?

Thanks, Jim. And congratulations on your PB in the 800. Very impressive swim. I am not aware of any data to suggest that your level of conditioning affects your risk of sudden death in long QT syndrome. It is known that exercise can pose more of a risk in certain genetic subtypes than others. Not to hijack this thread, but it looks like we both might make the TT in the 800 this year. Only 3 guys at nationals beat your time, and two of them were already ahead of you in the event rankings section, so you are now bumped to 7th. There was a guy at Cleveland who also beat your time, so by my reckoning, you are currently in 8th--with some leeway for other unreported stragglers. It could be close. Best of luck!

Is there a history of sudden death in your family? If not, your individual risk may be less. I agree with genetic testing. The concern is that lethal arrhythmias can develop during strenuous exercise in patients with long QT syndrome.