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Andersen Tawil Syndrome: Treatment, Cost and Side Effects

Last Updated: Apr 10, 2024

What is the treatment ?

Anderson –Tawil Syndrome which is also referred as Anderson Syndrome and Long QT syndrome 7, is a form of long QT syndrome i.e. LQTS. It is a condition which affects repolarization of heart after a heartbeat. This can result into an irregular heartbeat and later in palpitation, fainting, drowning and sometimes into sudden death. There is not any standard treatment though but the treatment varies case to case according to symptoms. The treatments available for this syndrome are medication, ablation or an implanted device to correct the misfiring, such as a pacemaker or defibrillator.

In case of medication, specific drugs known as carbonic anhydrase inhibitors, such as acetazolamide and dichlorpenamide, are used to treat periodic analysis in individuals with Anderson-Tawil Syndrome. It is clinically proved that dichlorpenamide reduces the frequency and severity of attacks of periodic paralysis. Also it is better to avoid the drugs which may prolong the QT interval.

In rare cases, treatment with an implantable automatic cardioverter-defibrillator or ICD is necessary. ICD’s are considered as a treatment in the patients who have sever cardiac arrhythmias. This device is implanted in the chest that detects abnormal heartbeat and delivers an electrical impulse to normalize the proper heartbeat. But this kind of treatment should only be considered after thorough consultation from medical heart experts and if it is genuinely necessary then one can go for such treatment. To take this treatment of ICD is a lifelong therapy that carries significant implications including the potential complications.

Other general precautions or we can say remedies are suggested such as, avoid potential triggers of periodic paralysis. It can be explained like a heavy exercise or rest immediately after heavy exercise. Daily potential supplement scan be beneficial to shorten the QT interval. But all this should be taken into application after expert medical consultation.

How is the treatment done?

The diagnosis of the ATS is based upon identification of characteristic symptoms such as periodic paralysis, irregular heartbeats and distinctive facial/ skeletal features. A detail history of patient and family is taken and thorough clinical evaluation and medical tests are carried out.

In some cases to obtain the confirmed diagnosis blood test can be carried out to determine the serum potassium levels, because potassium levels may be reduced during an episode of periodic paralysis. EKG records may reveal the prolonged QT intervals and abnormal electrical patterns related to ATS. Some individual also have to undergo a 24hr monitoring in which a small device is attached to the chest through electrodes and that device continuously records the presence, frequency and duration of ventricular tachycardia and other symptoms if any. The treatment for the ATS is carried out according to the symptoms of the individuals; the treatment may require a cordial team of specialists. If it is in case of child then pediatricians are included in the specialized team to systematically carry out the treatment. In adults if necessary an ICD device is implanted for continuous monitoring of the irregular heartbeats and if the device finds an irregular heartbeat it delivers the electric current and regulates the abnormal rhythm. But this type of treatment is carried out only if the ATS symptoms are life threatening.

In other cases in which the symptoms are rarely life threatening and many times the abnormal arrhythmias go away on their own without problems. In such cases some basic precautions would be recommended and with medication only the treatment can be carried out. Some tips like avoid over exercising, avoiding medicines that triggers the long QT interval and avoid rest immediately after exercise may help to regulate the heartbeat.

Who is eligible for the treatment?(When is the treatment done ?)

People with Palpitation, chest pain, frequent exhausting feeling and abnormal ECG/ EKG report that mentions long QT interval should do the further expertise medical test and consultation and once it is confirmed about the ATS are eligible for the treatment.

People with life threatening and frequent symptoms of ATS are eligible for treatment. The patients with associated left ventricular dysfunction need the treatment. Also if there is any family history of similar case and loss then it is advisable to consult for any further treatment. The treatment can only be done after final medical confirmation regarding the syndrome.

Who is not eligible for the treatment?

The person with minor and no life threatening symptoms are not eligible for the treatment. Minor QT interval is not recommended for the treatment. If the patient is not associated with left ventricular dysfunction may not need the treatment. If the ATS is not diagnosed and consulted by any of the official medical tests then it is not advisable to treat it by any medication only by EKG report. Kids with age less than ten years are not advisable for the treatment. Patients who are not having any symptoms related to the diseases or the conditions needed for the treatment are therefore not eligible for the disease. But the best advice can be given by the specialist doctor and therefore it is advised that the patient consults the doctor before the treatment.

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Are there any Side Effects?

A person undergoing this treatment of ICD implantation may face issues like bleeding, bruising, infection at the site of the procedure. Some may feel allergic reaction to anesthesia. These may be temporary side-effects which can be faced after surgery. However, the complications are very rare. Medication treatment may have side-effects which include drowsiness and sleepiness but it also varies case to case.

What are the post-treatment guidelines?

A person who had undergone this treatment of ICD implantation will require staying at the hospital till the doctor confirms the succession of the treatment. Patient may suffer from any side-effects which have to be monitored timely and hence need continue observation. Initial discomfort and some pain may be relieved by the pain killer medication. Doctor may advice you to have less contact with the electrical devices as it may interfere with the functioning of the implanted ICD.

How long does it take to recover?

The long QT interval, if it is genetic or inherited then there are less chances that it will go away. But with the treatment in the serious cases by implanting the ICD, the long QT interval may be under control. If you have a long QT interval caused by medication that you are taking or by mineral imbalance then it will most likely go away once you stop the medication. The recovery time for the treatment varies from one patient to another patient health condition. For some patients the medication may show positive results as soon as possible and some may report issues due to allergic or any other health related issues.

What is the price of the treatment in India?

The medication treatment would not cost you much as compared to implantation treatment. The treatment cost for the ICD implantation may vary as per the medical organization you visit. But generally in India, the treatment cost is between 45k to 1.5 lacks. However, superior varieties may have higher cost.

Are the results of the treatment permanent?

A person needs a regular visit to the doctor during the medication treatment and in case of ICD implantation patient need to visit doctor in regular intervals for three months. As the device is an electronic device so this may have some period of life. May be it varies from 5 to 15 year. After that your doctor may advice you to change it.

What are the alternatives to the treatment?

Alternatives to the treatment may be lifestyle changes. In which you can have a healthy and stress-free lifestyle to avoid any irregular functioning of the heart. Avoid medications which may increases the long QT interval condition. Do exercises which are healthy heart friendly.

References

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Written ByDr. Rahul Gupta MD - Internal Medicine,MBBS,DM - Cardiology,Fellow European Society of CardiologyCardiology
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