How can 2 EP doctors be so far apart on diagnosing me?

[Makwillster]

I’ve had tons of ekgs and a stress test and a holter monitor.  All normal results.  I had an ekg done at an urgent care that said long qt and it was 478.  My heart rate at the time was 105.  Ive had 2 other ekgs that were borderline long qt.  I saw an EP who looked through all my records and manually calculated my ekgs and said that after doing his calculations all my qtc values were in normal ranges of 380-420.  I am a worrier and saw a different EP to confirm I have nothing to worry about and he said he definitely thinks I have a long qt.  What?  He said he doesn’t think I have long qt syndrome, but that I just have a long qt.  He said he agrees with the computer printouts and says the computer printouts are usuallly pretty accurate.  I asked him to manually calculate one of the ekgs and he said he came out with a range from 460-490 on just one of them.  I don’t understand how there can be a 30ms range on one ekg.  Everything I’ve read says that they need to be manually calculated especially when the heart rate is over 100.  I was so relieved after my first appt and now I’m so confused and scared.  

[Careful35]

I certainly would go with the first EP.. This exact thing happened to me. More then a few of my EKGS came back either borderline or flat out long QT but in all those EKGS I had sinus tach so it was over estimated.. My EP measured them manually and said I did not have a prolonged QT in any of them...

I do have a family history of sudden death on my fathers side and have been suffering lightheaded spells since 2010 which were a rare occurrence once several months but the last year and a half the episodes have become frequent. Still I believe I do not have long qt syndrome...

You can have blood work done to see if you carry the gene for it. I am actually going to do the hereditary heart testing through color. They test 30 different genes for hereditary heart disease and 2 of them are for long qt syndrome. Just a thought.

[Makwillster]

Thank you so much for replying!  I ended up going to the regular cardiologist and he took a look at everything and said he absolutely agrees with the first EP.  He said after looking at all my testing he doesn’t see any indication of long qt whatsoever.  He said he’s not an EP, but knows how to decipher a true long qt on ekg and he doesn’t see it.  So, I’m finding some comfort with that.  I do have an appt with a 3rd EP at the end of Sept with who my primary care doctor told me is the best of the best. For the record my primary doesn’t think I have a long qt either, but gave me this guys name incase I wanted one more opinion.  

Good luck with your gene testing!! I’m sure everything will work out!

[tom_h]

This is strictly a layman's OPINION, but I would put my trust in the first EP who took the time to sit down, and manually calculate the time span.  I had an EP like that who spent extra time doing a little research.  Doing my procedure, he found a small overlap in my septal wall to sneak the catheter through and thus avoided the septal puncture.  He also told me the "computer analysis is BS", and are merely a guide, and a rough one at that.
Is your heart rate typically that high, or like me do you have Lab Coat Syndrome?  Finally, have you ever displayed any symptoms associated with long QT?  Fainting or seizures, family history, jumbled arrhythmia?  If it were myself, I'd listen to the first guy (or girl).

[Makwillster]

My heart rate is usually in the 60’s and 50’s when I’m at rest.  I def panic every time I get an ekg or any test done for that matter and my heart rate sky rockets.   I have never had any of the long qt symptoms and neither have my parents or grandparents, aunts, uncles, or cousins.  Im 36 and my sister is 39, she has never had any of the symptoms either.  I guess that is why atleast both doctors agree that I don’t have the long qt syndrome.  But the one seems to think I still have the long qt.   I want to believe the first doctor and wish I had never gone to get more reassurance because I got the opposite!!  Thank you so much for the reply!