Borderline ECG - long qt interval

[Bobandbear]

Does anyone know much about borderline ECGs or long QT syndrome? I’m 40 and recently had a ECG due to heart palpitations and my heart rate being slightly elevated when walking around the house etc. Nothing was said after my appointment and I was just given a copy of the ECG to pass to my GP. The ECG report says long QT interval, consider quinidine drug. CT / QTc is 412 / 493ms. I’ve just googled (always a bad idea) and I am now really worried.

I’ll be seeing my GP next week but does anyone have any experience or advice in the meantime please. I’ll see if I can pop a photo of the ECG report below. I also have low ferritin and was fairly anxious when the ECG was done.

it's a really poor quality ECG. The QT interval needs interpreting in the context of your medical history and blood tests (once a proper ECG's been done!).

@Greybeardy thank you for your reply, hugely appreciated. Do you do / interpret ECGs, please may I ask what makes it poor quality and if it’s poor quality does that mean less weight can be given to the long QT interval shown on here and that a new one needs doing? Thanks so much for your time, it sent me into a complete spin yesterday.

yes, i look at ECGs but less expertly than a cardiologist. There is a lot of interference and movement artefact in the ECG which makes it harder to work out where the different features of the ECG start/finish. Whoever did it should have recognised it as being pretty naff. If that QTc is correct (and it may well be) then it warrants some thought (not all long QTs are caused by long QT syndrome) and that is why the context of your medical history/medications/bloods etc is important. If the ECG was taken last September (which is what it says at the bottom) then it would need repeating anyway if you're still having symptoms. If you get more palpitations before seeing the GP then it'd probably be best to get medical advice then, otherwise, hopefully your GP will be able to reassure/make a plan.

I'd have a chat with your GP. For some people, a long QT is a normal variant, but for others it can increase their risk of arrhythmia.

The figures quoted are QT and QTC which is "corrected" for the heart rate. As your HR was 86 and you say that you felt anxious at the time, my first step would be to repeat the ECG.

I would also want to assess your medical history, any medicines you are taking and your blood chemistry. Depending on what the new ECG and fuller picture of your health looked like, a cause may be identified or it may be appropriate to refer you for further investigation.

@Greybeardy a @CarefulN0w thank you both for your detailed replies. They are really helpful. Yes the ECG was done in September, I was given the impression all was ok and should have dropped the copy into the GP for their records and I missed doing this (I’m usually really organised, we’d recently moved and life was hectic) and came across it last night, I’m so cross with myself.

I was referred for a Holter test in October when I went in for my blood results, as I’m still getting palpitations but it’s a six month wait. I will book a GP appointment for this week to discuss the ECG. @CarefulN0w thank you for clarifying that the higher out of range reading is a corrected one, does this mean that the higher heart rate caused by some anxiety (I’m not very good with medical issues!) may have had some bearing on the reading? Trying to understand it as best as I can, while I wait to get a full assessment.

I initially had a huge panic that I should have been taking medication since September to lower my risk of cardiac arrest when I googled last night (I know googling is always the worst thing to do but I was expecting something less scary), while I appreciate it could still be long qt syndrome, I massively appreciate you both taking the time to give a fuller explanation, as all my hours of googling only brought up the worst cases, your considered explanations have helped me to feel a little more settled while I wait to speak to the GP and have reduced the need for further googling! Thank you