Hi doctor, This morning I took my usual stimulant, but at a higher dose (Vyvanse 50 mg, rather than the usual 30 mg). In addition to the usual coffee, I have tried for the first time a dietary supplement with caffeine (200 mg), Niacin (10 mg, 50% daily value), and vitamin B12 (1000 mcg, 16,667% daily value). Now, I am experiencing accelerated heart rate and in particular, irregular heartbeat. It was usual with what I have taken so far, and I will not repeat this mistake. However, I would like to understand whether I need urgent care or not. I have attached the ECG, and I have recorded it with my mobile as it has a heartbeat sensor.
Hi. I welcome you and want to assure you do not worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. I have seen the heart beat monitored through your smartphone (attachment removed to protect patient identity). I want to assure you that this is not a big concern of medical emergency. You need not worry as it is a temporary increase in heartbeat. You will soon be normal. You need no antidote as your body will adjust at its own.  When there is a high dose of the stimulants in the body, the heart rate increases due to the effects of the drugs. Our heartbeat increase and it is sensed by the sensors. It leads to an increased parasympathetic activity and that causes a decrease in the heart rate and heart beat goes normally. This is a natural reflex activity that happens in all. You also will get normal heart rate and normal heart beat.  I do not think this is a medical emergency and you need not worry much. Relax and sit calm. I am happy to know that you will not do it again. It is necessary to know that if you will do it again and again it will have very dangerous effect on the heart and may cause severe damage or heart failure due to enlargement or sudden cardiac death which occurs in severe cases when heart gets an abnormal rhythm (arrhythmia). The heart beats in the mobile sensor are not reliable but I have seen hundreds of them. So when I decode yours, it is harmless for now. There is nothing significant. Nothing needed much. Take plenty of water and avoid caffeinated drinks of any type.