Medication induced Long QT Syndrome and EKG anomalies.

[Palpman]

Since I have been on Flecainide and Sertraline I have been worried about LQTS as both prolong the QT interval.

My GP was not concerned but I insisted on an ECG that I had done today.

It showed QTc Interval of 470ms. This is not good as it is higher than the top limit of 440ms.

I did a manual calculation that shows it to be 400ms. My heart beat is 60 so the calculation is simple.

Now i don't know what to believe and the mere thought of Ventricular fibrillation is scary.

I will however start cutting down on the Sertraline and see what happens. The other anomalies I will discuss later. Thanks for reading.

[jeanjeannie50]

Good for you insisting you have an ECG. Sometimes we really have to fight our corner for what we feel we need.

Will your ECG results be sent to someone higher in the cardiac medical profession? Are you under the care of an EP?

[Marytew]

Thank you for bringing this to our attention.

[Palpman]

I posted this to make members aware of LQTS and not to take 2 medications that both cause the prolongation of the QT interval. One is fine but not 2.

I have an appointment with Dr Bond, an electrophysiologist in May so will ask his advice on this.

[Coco51]

What was the result?

My own lifelong Bradycardia from mild heart block was manageable til I got AF and took Flec and Bisoprolol. That has prolonged one key interval (QRS? QT?) 400 I think. Though when I stopped Bisoprolol, it shortened again. But EP says Bisoprolol has to be taken with Flecainide. So now I have a pacemaker.

I suspected Flecainide has the same effect for me so your post interests me. It's a bit of a vicious circle with AF. Esp after 2 ablations. I'm tempted to go for a third to get off the drugs.

[Palpman in reply to Coco51]

Your ECG will show QTc duration of 500ms or longer before it gets dangerous.

A duration of 455ms is the maximum it should be.

Flecainide alone should not increase it to dangerous levels but can if taken together with antibiotics, antidepressants and some general anesthetics.

If you are elderly or have liver function problems the Flecainide could build up to toxic levels hence the requirement for 6 monthly or yearly tests.

Hypokalemia (low potassium), hypotension and bradycardia can also increase the QTc duration.

LQTS (long QT Syndrome) can cause dangerous ventricular tachycardia and sudden death. Torsades de Pointes can also precipitate to VT and this is not good. Cot deaths are now thought to be caused by this.

[Coco51 in reply to Palpman]

Thanks for the heads up. I do take these meds alongside BP meds, which control the BP well ( too well occasionally) . I have often wondered about drug interactions. And about whether the back up PM is strictly necessary but it's in action a lot of the time.

I am 69 and pretty active. Lost weight. BMI 23. Have yearly blood tests. Nuclear stress tests show no heart failure. Walk a lot. There was a scare when I had a GA and HR of 29. Never seen an anaeshetist look so worried, it freaked me out ( she was very young). But I had had a bleed and had low blood volume. They think that caused it. Anyway, that led to the PM recommendation.

I would love to sit down with a doctor who has time to look at all my meds, and at me generally, and work out if the treatment for one condition precipitates other problems. I live in hope!

Thanks again.