holter monitor results

[jennys1974]

Hi my dd had a holter monitor done resently and her results were apparently normal (second opinion was sort) and the dr doing the second opinion looking at the test results no the report said he was concerned about this figure max QTc 669ms this is found on page 6 in a small box with other figures which is the st analysis in the box section QT it has in it max QT 669ms (ch1) then max QTc 669ms  then it has % of max QTc>=450ms 3.8 %

If any one could explain what these figures mean that would be great my child is only 12

[spade22]

Is her EP doing any of the follow-up tests I mentioned above?

[jennys1974]

she had an eco done as well which revealed trivial tricupid regurgitation but then this  could be just a bored technition trying to make his reports sound more interesting. The tests were a follow up on a previous ecg which revealed tachy and enlargemen of one of her chambers which was due to a reaction to medication so onec the medication was removed we did the holter to doublecheck that it was just them meds but she was still experiencing pain on the left side and in her left arm and eposides of low blood pressure and a blusih tinge in her hands. doesthis help?

marfans was on her fathers side but she was screened for that when she was younger andit was ruled out

[spade22]

Hi,

QTc is the time taken for the heart to "recharge" between beats.  A "normal" value for a female is below 440 ms.  A value of 440-470 ms is considered "borderline high" and a value above 500 ms is abnormal.  

When QTc values start getting too prolonged (longer than 500 ms) this is cause for concern and, under certain circumstances, can result in potentially life-threatening arrhythmia's.  Borderline high values can indicate that a person may have a condition in which certain triggers can elongate the QTc into the dangerous areas.  It can also be a normal variant (2% of the population has  a QTc in the "borderline high" range).

From what I can gather from what you posted, 3.8% of the time your daughter has a QTc greater than 450 ms and a maximum QTc of 669 ms.  Based on this information, more tests might be needed.  Holter monitors are not perfect and the 669 ms is very concerning BUT this could certainly be an artifact/error.  

Rare genetic conditions, electrolyte imbalances,  and medications can cause elongation of the QTc interval.  Your daughter has shown at least a borderline high QTc value part of the time on her Holter monitor.  Again, more tests would be needed to determine what is going on and whether these numbers are "real".  A resting EKG, exercise stress test, blood work might be follow-up tests that your daughter will undergo.  Other information such as her, and your family history, and whether any arrhythmias were seen on her Holter test would also be useful.

Has your daughter passed out, had seizures?  Any history of this on your side of the family or on her fathers side?  Why was the Holter monitor indicated?

I hope some of the above information helps.