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Change in EKG
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Change in EKG

A brief history, I have rheaumatic heart disease, prosthetic mitral valve (1990), pulmonary hypertension, severe tricuspid regurgitation.  I've had three heart surgeries on mitral valve.  I developed atrial fibrillation and had av node ablation and pacemaker in 1999.  I had heart attack in 1998.  Recently had increased chest pain and rapid heart beats.  I saw EP cardiologist to see if the batteries needed to be changed in my pacemaker. The batteries were okay, but EKG showed increase in QTc to 495.  Previous was under 400.  Is this a normal variant for someone with a pacemaker?  Also the QRS is 166.  I know you cannot offer an opinion without the EKG but are these types of changes normal for a pacemaker?  I take Tracleer and coumadin, could either of these make EKG changes?  Thank you for taking my question, I hope it makes sense.  My 2 year old granddaughter wanted to do ABC's.  Thanks, have a good day.
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74076_tn?1189759432
Hi Kayl,

Is this a normal variant for someone with a pacemaker?

The QT interval varies based on heart rate, this variability is accounted for in the QTc.  There are still variations in the QTc based on multiple tangible and intangible factors.  A QTc of 495 does not present any significant danger and will likely decrease on your next EKG.  If you have an increase in your QRS duraction, this will also be reflected in the QTc.

Also the QRS is 166. I know you cannot offer an opinion without the EKG but are these types of changes normal for a pacemaker?

Paced rhythms tend to have a longer QRS and QTc.

I take Tracleer and coumadin, could either of these make EKG changes?

I did not find an association between tracleer and coumadin and QTc.  I just read the package insert.


I doubt this is anything to worry about.  Just ask your doctor to repeat your ekg next time you see him and I bet it will look better.

Have fun playing with your granddaugter -- they grow up quickly.

Thanks for posting.
8 Comments
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Avatar_n_tn
I assume that since no one answered it didn't make sense.  Thank you for your time.
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Avatar_m_tn
I cant answer your question but i am actually curious how you have all that information and didnt ask your DR to "explain" the results?I also wanted to let you knoe if you go to about.com and go into the cardio forum you can ask a dr
(DR RICH) in open forum and he is really smart and pretty good at explaining things....If he doesnt uinderstand your question he will work with you until he does:) good luck

ps..AGE?
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21064_tn?1309312333
I experienced a similar situation when I was being given an antiarrythmic in a hospital setting.  Had at least 4 EKG's over a 2 day period and once the RX was begun, the QTc interval jumped up to high 400's to low 500's.  Dr. said it was not a problem given my individual circumstances.  Like the Dr. mentioned, the variants in readings can be significant, or insignificant, given the individual's history and personal situation.

Hope the doctor's response gives you reassurance.  Have a fabulous day!

Connie
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Avatar_n_tn
Thank you for your responses.  I did not get a chance to ask the doctor about the EKG because the nurse handed me a copy as I was leaving.  All the EKG said was pacemaker.  I compared this most recent EKG to ones done after I got the pacemaker (i'm pacemaker dependent)  EKG's from 1999-2004 did not show increase in QTc.  One in 2003 showed increased QRS.  
    My heart rate for the most recent EKG was 77.  I will ask my doctor on the 29th next appointment.  By the way, I'm 52.  (my body feels ninety some days)  I guess I'm worrying for nothing.
     Note to Dr.  I did read the package insert.  Tracleer is contraindicated in persons with heart problems.  I was told this when I started taking it.  I was not offered anything else.  I was told that one other heart  patient (same doctor) had taken it and lived two years doing fine.  I was just wondering if the increased QTc and possibility of instant death was why it was contraindicated in some heart patients? Enough said.  I'm going back to play dinosaurs with my granddaughter.  Thanks again.  Have a great weekend.
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Avatar_n_tn
do you have the link for the about.com cardio forum?  I couldn't find it.

thank you
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Avatar_m_tn
go to about.com and click on heath& fitness then click cardio(on left of screen) you will see a bio for dr rich....click his name then click on contact the guide.....on the page "forum" will be highlighted click on it and ask away..(you will need to create a username and password...goodluck
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88793_tn?1290230777
Mine QTc is 475.  QRS is -62.  Could I know how to get the QRS changes from minus to positive?  

I understand what is Kayl said.  ECG wouldn't tell a thing, it printed like that:
"No further analysis attempted due to pacemaker rhythm"!  That's why sometime don't like to tell the Dr that I've a pacer.  

Also, does anyone know why in P Axis said Ind. then the QT, QTc and T Axis were no number come out?  Why?  Is that the technician turned it off or something wrong with the machine?

One Dr told me if the machine's battery didn't fully charged, it can mulfunction and printout the ECG with false report.  Is that correct or the Dr just telling a joke?

Pika
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