Question: Hello I am 43 yrs old female. 4 yrs back i had syncope and few months back twice. In all the cases fainting happened immediately after climbing and getting down the stairs or if i am walking fastly feel like falling down. I thought because i am suffering with cervical spondilities fainting has happened but orthopedic doctor has confirmed that my cervical pain is not so severe to cause fainting. In between I had high BP level going upto 170/90 so consulted Cardiologist who has taken 2D Echo (normal), Holter study (normal) subsequently doctor made me walk on TMT for few minutes and immediately ECG was taken and prolonged QT problem has came out. Earlier two times also prolonged QT problem has come but no medication was taken. Now, doctors have suggested (Dr XXXXXXX D XXXXXXX Dr.C.Narasimhan and Dr.Rajsekhar) for implantation of automatic cardioverter defibrillator. They have prescribed Concor 5 mg tablet later on increased to 7.5 mg. Sleep study was conducted and 106 apneas were identified. so I have taken onemore opinion i.e. from Dr XXXXXXX XXXXXXX Sr.Cardiologist Apollo Hospitals, Secunderabad. He asked me to consult chest physician first. I have consulted Dr.R.Vijaykumar, he says my chest x-ray is perfect and he suggested to use use CPAP machine for sleep apneas which i am using now. Chest physician has clarified that sleep apneas does not have impact on my fainting episodes.I have informed this to Dr XXXXXXX XXXXXXX Dr. XXXXXXX XXXXXXX asked me to use CPAP and come for review after 3 weeks. I asked him i will be using CPAP during night times whereas i am having problems during day time, then he said, your faintining episodes have no relation with prolonged QT intervals and says that ICD is not recommend as there doestn't see any serious problem with prolonged QT intervals and asked me use Concor tablet 2.5 mg daily. Now i am using Concor 2.5 mg daily but since past three days pain is there is chest left side when consulted Dr XXXXXXX XXXXXXX with ECG (day before yesterday again prolonged QT problem - report not attached) Dr XXXXXXX XXXXXXX suggested if I wish to go for ICD he is ready to implant ICD. Now i am delimma whether going for ICD is recommended or not? pls. suggest.

Good Morning Doctor 1, Can pls. let me how many days i have to use CPAP. 2. Highest Qtc noted was > 510 mS,QTc > 490 mS ( after 2nd syncope) and >460 mS (ECG dated 23rd Dec.2013 after 3rd syncope, TMT-report already attached) 3. Unconsciousness lasted for 1-2 minutes, in one case rescuer told the pulse was fast, some foam like liquid, very little came out of the mouth (in 2nd syncope) this happened in temple. in other cases not one checked the pulse, these episodes happened in train. Yes all the 3 syncopes happened after climbing the stairs and immediately after getting the stairs, i am having similar problem now also i try to go up and down the stairs, trying to avoid such situations. Nothing was given to me for making me conscious, as per the rescuers i came back to consciousness on my own. Doctor, i have similar problem while trying to climb or get down the stairs, trying to avoid such situations. 4. No idea. Polymorphic ventricular tachycardia is not mentioned in text form in my ECG. 5 coronary angiography and electrophysiology study was not done. Pls. suggest further. thanking you XXXX

Good Morning Doctor i dont have any idea about Ventricular tachycardia in the reports. 1) In mar.2013, ECG was taken wherein 510 ms QTC was recorded subsequently TMT was taken. 2) Again in Oct.2013 ECG was taken prolonged QT was noticed. 3) In Dec.2013 Dr XXXXXXX Nagaranjan made me walk on TMT and took ECG which recorded borderline prolonged QT > 460 ms - Doctor suggested for ICD. 4) In XXXXXXX Dr.Narasimhan asked to take 12 lead TMT with early recovery, with medication (5 mg concor tablet was taken before tmt) Conclusion for 12 Lead TMT: Test is terminated due to giddiness.No significant ST-T Changes seen during exercise with low work capacity (4.6 mets) & HR 107 BPM (60% THR)- Doctor suggested for ICD because of Genetic problem and 3 syncopes. 5) Dr.Rajsekhar seeing all these reports suggested for ICD. 6) Dr XXXXXXX XXXXXXX asked to use tablets for few days and suggested for CPAP. Due to pain in chest few days back ECG was taken which recorded prolonged QT 519 ms Some error is coming while attaching reports. I didnt use any medication apart from Thyrowel that too for few months only. Stopped using in XXXXXXX 2013 since thyroid was under control. Stil thyroid is under control. My weight is 90 kgs, height: 146 cm, BMI 42.4. Pls. advise further doctor Thanks XXXX

Good Evening Doctor. I have taken opinion of 4 doctors so far. 3 of them are good electrophysiologist who have suggested for ICD. Other one is Sr.Cardiologist in Apollo has finally concluded for ICD recently. Keeping aside syncope issue, pls. let me know will prolonged QT will cause sudden death. as per my ECG records, do you see any serious issue to be treated. I am using Concor 2.5 mg tablet now even then QT prolongation is there. What could be the reason for QT prolongation since past few years. Pls.reply. thanks XXXX