Should my wife lift heavy weights if she has Long QT syndrome?
My wife wants to lift heavy with the big three exercises and eventually wants to compete. But she has a heart condition. She has been diagnosed with Long QT when she was 14 she is now 24. The doctors have told her time and time again that she can not lift heavy weights but rather lift lighter weights for higher reps (15-20reps). She wants to get stronger, look better, get healthier and compete, but we are not sure if we should lift heavy or do what her doctors say.(which really wont get her strong) So we hope you guys can help with this question since you guys are doctors that actually lift unlike her doctors who are overweight.
She is quite healthy despite not really having any formal exercise experience. She has a resting HR of about 50bpm, she has a blood pressure of 110/70, she is also 5’5" and 125-130lbs, she also eats very well and manages stress the best she can. She takes 20mg of Nadalol once per day.
Long QT syndrome poses an increased risk of potentially dangerous ventricular tachyarrhythmias. Has she ever had one of these (or a cardiac arrest) before? If so, does she have an ICD?
In the literature I’ve seen on the topic, both exercise in general and the valsalva maneuver in particular have been shown to prolong the QT interval, which increases the risk of precipitating an abnormal heart rhythm in individuals with this condition. Fortunately, beta blockers (such as the nadolol she is taking) appear to abolish this effect and are a standard recommendation. The nadolol is also the cause of her low resting heart rate of 50/min.
It sounds like they have told her she can exercise “in general,” and she presumably will need to routinely use the valsalva maneuver in daily life (e.g., on the toilet). But unfortunately, that’s all the information we’re able to tell you as we have no data specifically looking at heavy resistance training in this condition with or without beta blockade. Because of this, we don’t know what the specific risks that you’re dealing with are, and beyond that, how much risk you’d be willing to accept.
She has not gone into cardiac arrest and she does not have an ICD. We also understand the consequences and have decided to take it slow. She’ll probably not chase performance, but rather health and of course muscle growth and asthetics but she will probably not enter any competition. Thanks for the response it is appreciated.