how long does it take to develop left atrial abnormality?, which is what patient s initial evaluation EKG showed. do EKG, with other labwork, to determine any underlying medical issues. can it be caused by a low dose of elavil after only 1.5 weeks?, don t believe it to be the elavil but want to make sure secondary to its known cardiac side effects. patient also history of chronic pain and long history prescribed opiates for that pain, and long history of insomnia