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Q. How to bring my PR interval back to normal from 118 milliseconds?

Answered by
Dr. Muhammad Zohaib Siddiq
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 02, 2022

Hello doctor,

I had my annual physical check-up yesterday, and my EKG showed a shortened PR interval (118) with no Delta wave. This is new, my test last year was 130. I have a long history of super ventricular tachycardia episodes (diagnosed by a cardiologist) that I have always been able to control with vagal maneuvers, etc. Yesterday morning before my exam, I had one of these SVT episodes that lasted a while. I assumed it was triggered by hormones, as I am currently ovulating and I am in perimenopause and experiencing lots of symptoms with each cycle. But now I am worried it is something else. The episode was over a few hours before my test, but I was still tired and a bit dehydrated from it.

I am a 49-year-old woman. I have good blood pressure, cholesterol levels, a healthy weight, and do yoga. I do have other types of health issues such as fibromyalgia, mild POTS, migraines, IBS, mast cell activation issues, food intolerances, etc.

I was referred to cardiology for follow-up and I have an appointment but it is still three weeks away, and I am really worried this could be something serious. My father had an arrhythmia in midlife as did his mother.

My chest is sore today, but it is not "chest pain," it is more like sore muscles, which I have had before following SVT.

Should I be worried? Would appreciate any information or reassurance. Thank you.

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#

Hi,

Welcome to icliniq.comYour PR interval is not short. It is normal. If there is an accessory pathway in heart that causes SVT (supraventricular tachycardia) will be diagnosed on EP (electrophysiological) study. If symptoms are frequent or bothersome, EP study and ablation is advised.

I would suggest having an echocardiography done. I hope it is already done and is normal. You need not worry if there is no delta wave in repeated ECG (electrocardiogram). If you had episode of syncope due to uncertain cause then EP study is must.

Regards.

Hi doctor, Thank you so much for the thoughtful reply. My doctor told me anything under 120 was abnormally short, so very glad to hear 118 is a normal variant. I have had two echocardiograms in the past, the last one was about four years ago. They have always been normal. Is it likely anything that significant would have changed? I have not had any episodes of syncope, and my SVT episodes are not too frequent, so hopefully if my next ECG does not show anything else off I need not have to pursue it further? I really appreciate the reassurances, it will be much healthier for me feeling better about this while I await my follow-up appointment. Thank you.

#

Hello,

Welcome back to icliniq.com.PR interval normal range is 120 to 200 milli seconds, so 118 ms is just 2 milliseconds short and is not considered abnormal especially if there is no delta wave. Short PR interval is not dangerous per se if one does not have high risk features like syncope. If you you have recurrent SVT despite medicines, then EP study with ablation is an option to treat it, otherwise no worries. As you said one of your ECG was normal with 130 ms PR interval, so even if we consider 118 ms short PR interval, it is not high risk because it is intermittent. Regards.


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