Is a QRS interval of 164 ms dangerous?

Hello doctor,

I have been having sets of muscle twitching in different places of my body and arrhythmias that come and go. They feel scared, and I fear sudden cardiac death or hospitalization. I received an abnormal EKG with RBBB, and a wide QRS interval exceeding 164 ms. I am on blood pressure medications Losartan/hctz 100/25 mg, Carvedilol 6.25, and Spironolactone 25 mg; I have been active most of my life. I lift weights and do workouts. I had a Cardiac MRI last year that was normal. These skipped beats are scary; I wore a Holter monitor that showed a three-beat run of SVT. Please advise, can I work out? Should I worry about the risk of sudden death?

I am worried about sudden death arrhythmias due to having a wide QRS. Is my QRS being 164ms dangerous for me? Why did my cardiologist not explain this to me if it is this high? I am worried about complications to my health.

I have had these arrhythmias in the past, which usually last one to two weeks. Some episodes involve one to two light flutters, while others consist of consecutive beats, causing shortness of breath and anxiety with muscle twitches. I eat a well-balanced diet, and I am not dehydrated or malnourished.

Thank you.

Thank you for the reply, doctor.

I have had these palpitations for 11 years, around the time I first went on blood pressure medication. They seem to come on and last about a week to two weeks, sometimes a little longer. The most common are one to three skips, but I have had one episode of several in a row that was very scary while lying down, which caused me to get up and try to catch my breath while it was beating out of rhythm. The muscle twitching has just been noticeable in the last few years. It feels like something is happening with my electrical system; something gets thrown off when I have palpitations and a muscle-twitching onset. I was wondering what brought these on, but there seems to be no reason. They are random, as my last episode was four months back. Last year lasted a little over two weeks.

The muscle twitching is light but in different parts of the body throughout. I seem to get them at about the same time or after the palpitations.

My family history only includes my mother, sister, and grandmother, as I do not know my father or that side of my family. My mother is in her 50s and rarely sees a doctor, but she probably has hypertension. My sister, like me, has high blood pressure and has been on medication since early adulthood, but no other known complications. My grandmother has had blood pressure issues since young adulthood and has a pacemaker she got in her 50s due to a heart issue she had. She is still with us in her 70s, but none of them are active or workout quite like me. My great-grandmother on my mom's side had several heart attacks and was a heavy smoker but did not take care of her health as much; she passed in her 50s, I believe.

I am concerned, after reading online, about why my doctor did not alert me about my QRS being 164 ms. Everything I have read talks about how dangerous it is and how sudden death or serious complications are associated. She listed it as RBBB, but online says RBBB is a QRS between 120 ms to 140 ms. Higher than that is likely VT (ventricular tachycardia), which is what I am worried about being mistreated, and it is getting worse which is why I ask for your expertise. My resting heart rate is usually between 50 to 70 bpm; laying or sleeping can be in the 40s, but I am not symptomatic of this slower HR and I have had it for as long as I can remember since 11 years when I started tracking my health.

Thank you.

Thank you, doctor, for your reply.

Here is a better picture of my last EKG. You can read it now to see the QRS duration. I will also attach the last Holter monitor results that I did back in last year. Please let me know what you think. Do I need to worry about this? I want to live a healthy life for my kids. I am 33 years old, so I want to do everything right, and hopefully, we are not overlooking something potentially fatal or damaging to my heart over time. Should I still be fine working out and pushing myself? I was interested in possibly doing the police academy, that has an air of agility and running. Should I lay off of it a bit? I already eat healthier than most, but this just makes me worried.

Thank you, doctor,

Looking forward to your reply, thank you for all you do. Your work is priceless.