Alicia Hallock

Robert and Blanca Hallock’s two sons were already grown and almost out of the house when Blanca learned she was having twins. The arrival of Alicia and Alexa Hallock not only changed the lives of these nearly-empty-nesters, it brought the family some unexpected medical problems.

Although fraternal twins, Alicia and Alexa looked alike and seemed to enjoy the same toddler activities. But Robert and Blanca soon noticed that Alicia often looked tired and had dark circles under her eyes.

Blanca worked in a doctor’s office and knew that children had relatively fast heart rates compared to adults. One night, Blanca happened to put her hand over Alicia’s chest and noticed her heart beat was slow. She took the girls’ pulse rates and found that while Alexa maintained a relatively normal pediatric rate of around 120 beats a minute, Alicia’s heart beat about half that speed—around 60 beats a minute.

The cardiologist confirmed that Alicia had a disorder known as 2:1 AV (heart) block.

Heart block affects the heart’s electrical system. Alicia’s heart muscle was strong enough to pump efficiently, but the electrical signals that caused the upper chambers and then the lower chambers of the heart to beat in sync with each other did not function correctly. In Alicia’s case, for every two beats the top chamber of the heart tried to initiate, only one got conducted properly to the bottom chambers, which pumped the blood. That meant that while Alicia’s heart was trying to beat at the same 120 beats per minute rate as her sister’s healthy heart, Alicia’s heart could only produce an actual heart rate of around 60 beats a minute—much too low for a toddler.

Alicia was also diagnosed with prolonged QT syndrome. Robert and Blanca were told that long QT syndrome is usually hereditary. By chance, Blanca learned that her recently deceased mother had the syndrome, which can increase a person’s chances of sudden cardiac death. “My mother never knew she had long QT syndrome,” Blanca commented. “We only found out by accident, after she died. But we had everyone tested.” Alexa did not have the condition.

Alicia was just a baby when she went for surgery. Blanca and Robert were concerned not just with the results of the operation but her future. In particular, they were worried about any scar the surgery might leave and what her limitations would be.

Under the guidance of her pediatric cardiologist, it was decided that in order to manage her long QT syndrome, Alicia would be put on a regimen of beta-blockers, a highly effective drug for this condition. One of the possible side effects of beta blockade is that it slows the heart rate. Some people who take beta-blockers long term end up getting a pacemaker to manage a slowed heart rate. For Alicia, the pacemaker that helps her AV block also keeps her on track from any possible slowdown of the heart rate caused by her beta-blocker therapy.

“Today, you can’t tell them apart,” Blanca stated. Now four years old and living in Las Vegas, the twins enjoy playground activities, running around the house, and playing with dolls.

Blanca and Robert were also concerned about their young daughter having a big scar from the pacemaker surgery. “It’s really not bad,” Blanca reported. Alicia is at the age where she is very willing to show visitors her “owie” where the operation took place. Like other infants who get a pacemaker, Alicia’s pacemaker was implanted in her abdomen. She has a tiny whitish scar that marks the place where the device is located.

“It’s awesome what a pacemaker can do,” Robert and Blanca agreed. There are some restrictions on Alicia in terms of physical activity, specifically to avoid getting hit in the area of the pacemaker. She is not allowed to play contact sports or jump on trampolines or play on monkey bars. These limitations are aimed at helping protect the pacemaker and the wires that run to her heart.

“She’s a strong-willed little girl, and she is determined to keep up with her sister,” Blanca commented. “She knows her limits, but she pushes right up against them all of the time.” Robert and Blanca both smile when they think about Alicia and her competitive attitude. “She’s going to be fine.”