• Health & Fitness

Long QT syndrome: A swimmer's perspective

Queensland ocean swimmer, Hillary Geers, shares her experience being diagnosed with and managing Long QT syndrome as she takes on longer distances.

We all love the health benefits swimming provides us with, ranging from heart health to mental health, but, did you know that, whilst relatively rare, swimming can also be a trigger of a life-threatening condition for some?

Long QT syndrome is a heart-signalling disorder that can cause arrhythmias, a fast, chaotic heartbeat, and it can affect fit and active people, including swimmers, out of the blue.

A person with Long QT syndrome may experience symptoms when exercising or at times of emotional excitement.

In this article, we hear from Hillary Geers, a fit, active and healthy open-water swimmer that, at the age of 48, was diagnosed with Long QT syndrome, and explore more about the syndrome.

A diagnosis anything but routine

Geer’s diagnosis was discovered after undergoing a routine electrocardiogram (ECG) while undergoing a medical clearance to enter a marathon-distance swim in France.

“I had no Long QT syndrome symptoms and it was only because I needed an ECG for my medical clearance to enter a 10km swim in Nice, France, that I even found out,” said Ms Geers.

“It’s funny because only a few weeks prior to getting my ECG I had completed a 10km swim in Auckland and then the next weekend I did the 10km swim from Burleigh to Surfers Paradise.

“Then after my Long QT syndrome diagnosis, I was immediately banned from all swimming, both pool and ocean swimming at the risk of losing consciousness in the water causing sudden death.”

Ms Geers has since returned to the water under the guidance of her electro cardiologist to manage her Long QT episodes and allow her to once again enjoy the freedom of ocean swimming.

“The fact that I have Long QT is always on my mind and I am hyper-aware every time I swim now,” said Ms Geers.

“I work closely with my electro cardiologist who specialises in cardiac arrhythmias and while he would prefer I didn’t swim in the ocean, he also recognises my need to live a full life and ocean swimming is a part of that.

“To manage my condition, I never miss taking my medication (beta blockers), as not taking them can trigger a rebound fast heart rate.

Ms Greer and Mr Clayton

“I also do everything physically possible to prepare for my open water swims, by swimming 5-7 km every day in the pool with my coach, and then on weekends, I enjoy open water swimming at Burleigh with Phil Clayton. I also always swim with a tow float when open water swimming.

“Both of my coaches have been amazing and incredibly supportive in allowing me to swim while I deal with Long QT syndrome.”

Ms Geers’s journey back to the water while managing her Long QT syndrome hasn’t been all smooth sailing, admitting there have been a few hiccups along the way.

“When I was first put on beta blockers to stop my heart rate from going dangerously high and triggering an arrhythmia, it dropped my resting heart rate to 28 bpm,” said Ms Geers.

“This ended up putting me in the hospital and we ended up changing the type of beta blocker I was on, but my heart rate still remained very low.

“Because of this, I had to have a pacemaker (not an ICD) installed that now paces my heart at 60 bpm.

“So, I have the beta blockers to stop my heart from going too high and my pacemaker to stop my heart from going too low.”

Ms Geers hasn’t let having Long QT syndrome stop her from enjoying her love of the ocean and is now an avid long-distance swimmer.

“Since being diagnosed with Long QT syndrome, I only do distance swimming events and plan on taking it to new heights,” said Ms Geers.

“Last year, I completed the 20km Swim Around Keppel, the Robben Island crossing in Cape Town and the 5km Bondi to Bronte. I also swam 37 km in 12 hours in the MS swimathon.

“I just did the U24km swim from Safety Beach to Sorrento Beach in Melbourne on the weekend and have plans to swim 1,600km this year as part of The Endurance Swim Challenge on Facebook.

“I still want to go to Nice and do the 10km swim over there but to be able to swim in France you require a normal ECG and that is unlikely to happen for me.”

Long QT syndrome

What is Long QT syndrome?

Long QT syndrome is a heart-signalling disorder that can cause arrhythmias, a fast, chaotic heartbeat.

A person with Long QT syndrome may experience a fast, erratic heartbeat when exercising or at times of emotional excitement.

There are two types of Long QT syndrome; congenital Long QT syndrome and acquired Long QT syndrome.

Congenital Long QT syndrome is when a person is born (inherited) with altered DNA, whereas, Acquired Long QT syndrome is caused by some medical conditions, certain drugs or mineral imbalances.

Signs & symptoms of Long QT syndrome

Many people with Long QT syndrome don’t have any noticeable symptoms, although the primary and most obvious symptom is fainting (syncope). These fainting spells can occur with little to no warning.

Other symptoms include:

  • Lightheadedness
  • Weakness
  • Blurred vision
  • Pounding heartbeats (palpitations)
  • Seizures
  • Fainting (syncope). These fainting spells occur when the heart temporarily beats in an unorganised way. This can happen when you are excited, angry, scared or startled or during exercise such as swimming which can be fatal if you lose consciousness in the water.

Research shows roughly one-third of people who have Long QT syndrome do not show any symptoms.

Trigger of Long QT syndrome

A Long QT episode can be triggered by a multitude of things including:

  • Exercise, such as swimming
  • Stressful situations including exams
  • Emotions including anger and excitement
  • Being in scary situations
  • Being startled by a loud noise, such as an alarm clock or a ringing telephone

What causes Long QT syndrome

Long QT syndrome is a heart rhythm condition that is caused by changes in the heart’s electrical recharge system. This is when the heart’s electrical system takes longer than usual to recharge between beats.

In a non-Long QT heart, the heart sends blood out to the body through each heartbeat. The heart’s chambers contract and relax to pump blood. This is controlled by the heart’s electrical system.

The electrical signals in the heart travel from the top to the bottom of the heart, telling the heart to contract and beat. After each heartbeat, the system recharges to prepare for the next heartbeat and to send blood throughout the body.

Whereas in a Long QT syndrome heart, the heart’s electrical system takes longer than usual to recharge between beats. This delay is called a prolonged QT interval and can be seen on an electrocardiogram (ECG).

Risk factors that can increase the risk of developing Long QT syndrome

Long QT syndrome can develop from an array of pre-existing conditions or from undertaking certain activities that can increase the risk of developing Long QT syndrome.

  • A history of cardiac arrest
  • Using medications known to cause prolonged QT intervals with the heart
  • Eating disorders, such as anorexia nervosa, which cause electrolyte imbalances
  • Having a parent, sibling or child with Long QT syndrome
  • Being a female and taking heart medication
  • Excessive vomiting or diarrhea, which causes electrolyte imbalances

Diagnosing Long QT syndrome

Long QT syndrome can only be diagnosed by a medical professional, through an electrocardiogram (ECG) or genetic testing.

Medical professionals will monitor the symptoms and put together a health management plan to manage Long QT syndrome.

Managing Long QT syndrome

Managing symptoms of Long QT syndrome is extremely important to ensure it does not turn into a life-threatening event.

Regular health check-ups and good communication with your GP and cardiologist will help to manage symptoms and monitor the condition to determine if it is progressing.

If you have Long QT syndrome it is important to tell your doctor that you suffer from the condition before they give you a prescription as some medications can affect the heart rhythm which can increase your Long QT syndrome symptoms.

Unfortunately, there is no prevention for Long QT syndrome but there are multiple treatments such as beta blockers and implantable cardioverter-defibrillators (ICDs) which can help manage symptoms for Long QT syndrome and ensure a full and healthy life is lived.

  • Written by Ocean Swims on 20 February 2023
  • (Updated on 3 August 2023)

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