Alicia Bravo: Long QT Syndrome
As an emergency room nurse at a Minneapolis trauma hospital for more than 20 years, Alicia Bravo is passionate about increasing awareness about the importance of bystander CPR to help save lives. Alicia never could’ve imagined however, that CPR would one day save her own life. It happened one day in July 2017 when she experienced sudden cardiac arrest while swimming at her parents’ lake home in the small Wisconsin town where she grew up.
“I was 37 and had a sudden cardiac arrest and I had no idea why,” said Alicia. “I had been training for triathlons and was in the best shape of my life. Just six days before, I had done a mile swim race at Lake Harriet … it’s insane.”
Just five minutes into her training swim, Alicia’s heart went into V-fib (ventricular fibrillation), a life-threatening heart rhythm that occurs when the heart’s lower chambers (ventricles) quiver, or fibrillate, instead of contracting (or beating) normally. V-fib can cause sudden cardiac arrest (where the heart stops beating) and is the most common cause of sudden cardiac death. Thankfully, her father, husband and the sheriff all took turns performing manual CPR before EMS personnel were able to hook her up to a LUCAS machine, an external mechanical device that delivers consistent and uninterrupted automatic chest compressions during CPR.
“I just feel like I'm really lucky; I'm thankful to be alive,” said Alicia. “I try to do a lot of outreach teaching people CPR because without it, the outcome would've been completely different. I had CPR for 20 minutes and today, I'm totally normal and living a normal life.”
Alicia eventually learned she has Long QT syndrome, a relatively rare and often inherited heart rhythm disorder. Long QT is characterized by fast, abnormal heartbeats, which increases the risk for fainting, seizures and sudden cardiac arrest. Alicia had two different types of stress tests and also genetic testing, which showed no genetic markers for Long QT.
After initially being treated at a hospital in Madison, Alicia returned home to Minnesota and began seeing Dr. Jay Sengupta, an electrophysiologist at Allina Health Minneapolis Heart Institute (MHI). Dr. Sengupta serves as director of MHI’s Genetic Arrythmia Center (GAC), a unique multi-disciplinary clinic that integrates world-class clinical care, genetic counseling and clinical research for patients and families facing cardiac conditions that predispose them to sudden cardiac death and cardiac arrhythmias. Dr. Sengupta also leads the Heart Rhythm Center at the Minneapolis Heart Institute Foundation (MHIF), where researchers maintain a GAC registry (database) of more than 500 patients. This database allows them to study rare inheritable heart rhythm disorders such as long QT and help improve diagnosis, therapy and outcomes.
“I’d been a nurse for 15 years and I had no idea what Long QT syndrome even was at the time; I didn't realize it was so dangerous to have,” said Alicia. “I wanted to get my care at a heart institute that has really good research and a hospital dedicated to that; that was important to me. I actually had no idea about the Genetic Arrythmia Center when I chose MHI, so I was excited to be offered that opportunity right away. The staff was absolutely amazing and determined to figure out my condition.”
Although she wasn’t aware of it at the time, Alicia was also able to benefit from MHIF research during her emergency care in Madison. Doctors there had implemented the COOL-IT therapeutic hypothermia protocol to lower her core body temperature, which helps reduce the chance of permanent brain or neurological damage — a risk following sudden cardiac arrest. MHIF researchers developed this lifesaving treatment protocol, which has been implemented by hospitals across the country.
Today, Alicia has a dual implantable cardioverter-defibrillator (ICD) and pacemaker, and she takes a beta-blocker medication to slow her heart rate and make the abnormal rhythm associated with Long QT syndrome less likely. She still stays active, but can no longer do competitive sports as she needs to ensure her heart rate doesn’t go above 170 beats per minute when exercising.
“My life is great; I feel safe with my ICD,” said Alicia. “I'm just so fortunate that everything aligned that day, and everyone was there to help me. I'm thankful that I can spread the word on bystander CPR; it’s really important to me.”