Arrythmia - Holter test result -Ritalin

[BamBam700]

Hello ,
I'm 22 years old male.I am not hypertensive nor diabetic. The symptoms has started  after i used Ritalin. The doctor did echo. It is normal. My holter results are below.

Conclusions :

The average heart rate was 71. The minumum heart rate was 39 at 01.10. The maximum heart rate was 168 at 10:07 ,pauses greater than 2.0 seconds were 0. Ventricular ectopy was 54 with 1 V-Runs and 4 V-Pairs , Venticular Bigemy events were 0 , trigemy 0. Supraventricular 14 with 1 SV-Runs. Supraventricular trigemy bigemy 0 . Total A-Fib(Flu) were 0 min 0 second. The patient pressed the symptom event button 2 times on the Holter recorder.

Longest V-Runs : 3 beats at 21:13
Maximum HR V-RUN: 203 bpm at 21:13
Ventricular R on T : 16

Supraventricular Ectopy:
SVE: 14
SV-Run Total : 1
Longest SV-Run: 6 beats at 22:47

QT:
Max QT: 468 ms
Max QTc : 542 ms
Time of max qt at 12:10 HR 87bpm
BBB: N/A

For 2 months i walk 5 km everyday. I think my hearth reached its maximum rate 168 today while i was walking. As i walking happened 11 VE - 1 V-pair. It looks like it increased as i exercise. Is it dangerous ?

What is V-RUN ? Is it dangerous ?

My minimum heart rate is 39 when i was sleeping. Is it normal ?

Thank you.

[BamBam700]

I went to 3 different cardiologist. This is my second holter test. I dont know that there was qtc analysis or not in first holter. First holter test result was better. 3 r on t , 1 pvc couplet , 40 pvc.  all doctors told me same thing but im not sure they have enough experince for long qt. Is there any test for long qt ? I hear asmial , ajmial test or something like that gives %100 result.

[is_something_wrong]

I find Prozac in the "low but possible risk of LQT" at www.torsades.org.

Anyway, this is something you must discuss with your doctor, do not change medications or dosages without consulting him first.

The LQT syndrome (LQTS) is genetic, but it can occur without your parents having symptoms. Some people have prolonged QT time in some settings, without having LQTS. It's actually a lot more common than LQTS itself (2,5% vs 0,025%)

I think doctors disagree a bit regarding the significance of R on T. I don't know how common it is (doctors have told me different), but I think you should ask a cardiologist.

I understand you are scared, and it wasn't my intention to add fuel to the fire here, but it's always best to be sure, and I advice you to ask a doctor. If it's nothing to worry about, you can get this out of your mind easier, too.

[BamBam700]

thank you for your reply. is prozac prolonging qt time? Im using it for 1,5 months 15 mg everyday. %19 >450ms qt. i went to doctor he said nothing worry about. My family members living for 90 years. My grandfather , mother are still alive. My father is 50 years old smoking 3 boxes of cigarette , drinking 1 bottle of turkish raki evryday he is still alive :) as far as i know long qt is genetic ? Is r on t very uncommon for healthy hearts ? im scared

[is_something_wrong]

Hi,

First: The minimum heart rate of 39 while sleeping is normal. Mine was 38.

You should discuss this monitoring with a cardiologist, because some things are a bit concerning. The R on T PVCs, in the setting of prolonged QT time is possibly dangerous, as far as I know. It can, in some cases, trigger a dangerous ventricular arrhythmia.

I don't think a PVC triplet is any concern, neither the couplets, the short SVT run or the other PVCs.

The fact that PVCs increase during exercise can as far as I know be a little concerning, it all depends on the setting. Anxiety during activity can also cause PVCs, in this setting it's usually benign.

I'm not a doctor, and I can't give you any specific advice and answers, except one, and I hope you take my advice seriously:

Ask for an appointment with a cardiologist, discuss these findings, and find the reason for your possibly prolonged QT time and R on T PVCs (that possibly are connected), and the ventricular ectopics during exercise. Do you use antidepressants? Other drugs? I don't think Ritalin is prolonging QT time, but I can't say for sure, your doctor knows.

Good luck, I hope you don't get too scared, and this is not necessarily dangerous, but it should be evaluated by a cardiologist without too much delay, I think.