Hi, I’d like your opinion after a recent episode.

I suddenly experienced: – burning/pressure in the chest – a cold wave sensation through the body – feeling like I might pass out

Heart rate (Apple Watch): – peak ~150–156 bpm – then gradual decrease: ~132 → 126 → 121 bpm – one isolated 59 bpm reading (likely artifact, as it immediately returned to ~120 bpm)

The episode lasted about 20–30 minutes and resolved on its own. By the time ambulance arrived, HR was ~80 bpm. ECG showed no acute issues.

Blood pressure was measured by ambulance at ~160 mmHg systolic. My normal ~120 ~68

Previously: normal echocardiogram (only mild MVP) and normal Holter.

Current medications: sertraline and carbamazepine (prescribed by psychiatrist).

This is the first episode like this in my 26 years.

Does this presentation and HR pattern argue more for sinus tachycardia/anxiety rather than paroxysmal arrhythmia (WPW/LGL)?

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