Question:

What treatment options are there for one who has long q-t syndrome and narcolepsy?

I don’t have a solid diagnosis yet, however I have lots of episodes where my heart rate goes over 130 (probably higher during bad episodes though) and I have a prolonged q-t interval. I have been hospitalized twice so far. I have narcolepsy though, and if I take beta blockers, I will have no quality of life due to extreme fatigue (which I have even without beta blocker treatment). Are there any other treatment options? Would I qualify immediately for an ICD? I can find no information on long q-t syndrome in a narcoleptic. I wouldn’t be surprised if it has never happened before though! Thanks.

Submitted by Katie from Northern Ireland on 05/12/2014

Answer:
by Mohammad Saeed, MD

The first thing is to establish a diagnosis of the arrhythmia. This could be accomplished by heart rhythm monitoring of various durations. If episodes are frequent then a 24 or 48 hour heart rhythm monitor may be able to catch the arrhythmia, otherwise 30 day monitor may be suitable. Once it is established what the specific type of arrhythmia is, then appropriate treatment options can be considered. If you have a ventricular arrhythmia, then an ICD may be the best treatment.