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Having Rapid Heart Rate At Night. On Holter Monitor. EKG Done. Looking For Suggestion

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Posted on Thu, 21 Mar 2013
Question: By looking at this ekg is it possible to have long qt syndrom the reason I ask is I have been having episodes of waking up in the middle of the night with my heart racing or if the alarm clock goes of I feel my heart like jumping all over the place for a few minutes then it goes away I am currently on a holter monitor for three weeks must wait on results a month from now.
doctor
Answered by Dr. Shoaib Khan (38 minutes later)
Hello and welcome to XXXXXXX

Thank you for writing to us.

I have looked into your EKG. And along with your main query, I also noticed a few other abnormalities. I shall list them all for you.

1. QT/QTc interval is indeed prolonged (also called Torsades de Pointes), which means you would have to seek immediate medical attention for the same. (Please avoid any disturbances at night, especially the alarm clock, kindly find an alternative. Also, please avoid all forms of exercise for a while. Physical activity is fine, but no exercise please. Visit a doctor, a course of beta blockers should also help, as you are at a high risk with QTc interval of > 500 ms)

2.The 'm' shaped complexes seen in your EKG indicate a block (do not mistake this for a layman's understanding of a block in the heart, it is a condition which is named a block). Due to the presence of this feature in different parts of the EKG, the block is called an intraventricular block

3. Inverted 'T' wave: the causes for this particular finding in the EKG can be the following: the bundle branch block (we spoke about in point 2), ischemia of a part of the heart, ventricular hypertrophy, hypertrophic cardiomyopathy

These are the findings. Please consult a doctor at the earliest ma'am, I wouldn't wait for the results of the holter device, as this is time consuming. I would also like to mention that long QT syndrome is either congenital or acquired. You seem to have the acquired form, this is usually caused by medications (astemizole, terfinide, cisapride, quinine, procainamide, bretylium, ibutilide, dibutilide, amiodarone, sotalol) plus risk factors (female sex, cardiovascular disorders).

I hope this information helps. Do write back to me for any further clarifications or information. I would be glad to help. Please do take care.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (4 minutes later)
Thank you for your quick reply
doctor
Answered by Dr. Shoaib Khan (2 minutes later)
I am glad I could be of assistance ma'am.

Prolonged QT syndrome will require immediate management as it increases the risk to a number of serious cardiovascular events. Thus, as requested earlier, do consult a doctor and be supervised by him/her at all times.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (1 minute later)
Thank you I will see my doctor ASAP.
doctor
Answered by Dr. Shoaib Khan (1 minute later)
Thank you XXXXXXX. Wishing you a long, beautiful and life.

Best wishes.
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

Answered : 9409 Questions

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Having Rapid Heart Rate At Night. On Holter Monitor. EKG Done. Looking For Suggestion

Hello and welcome to XXXXXXX

Thank you for writing to us.

I have looked into your EKG. And along with your main query, I also noticed a few other abnormalities. I shall list them all for you.

1. QT/QTc interval is indeed prolonged (also called Torsades de Pointes), which means you would have to seek immediate medical attention for the same. (Please avoid any disturbances at night, especially the alarm clock, kindly find an alternative. Also, please avoid all forms of exercise for a while. Physical activity is fine, but no exercise please. Visit a doctor, a course of beta blockers should also help, as you are at a high risk with QTc interval of > 500 ms)

2.The 'm' shaped complexes seen in your EKG indicate a block (do not mistake this for a layman's understanding of a block in the heart, it is a condition which is named a block). Due to the presence of this feature in different parts of the EKG, the block is called an intraventricular block

3. Inverted 'T' wave: the causes for this particular finding in the EKG can be the following: the bundle branch block (we spoke about in point 2), ischemia of a part of the heart, ventricular hypertrophy, hypertrophic cardiomyopathy

These are the findings. Please consult a doctor at the earliest ma'am, I wouldn't wait for the results of the holter device, as this is time consuming. I would also like to mention that long QT syndrome is either congenital or acquired. You seem to have the acquired form, this is usually caused by medications (astemizole, terfinide, cisapride, quinine, procainamide, bretylium, ibutilide, dibutilide, amiodarone, sotalol) plus risk factors (female sex, cardiovascular disorders).

I hope this information helps. Do write back to me for any further clarifications or information. I would be glad to help. Please do take care.

Best wishes.