<s>[INST] My son is 19, never used drugs, never drank. He has an occasional rapid heart beat then tingling in both hands. Went to Dr..wore monitor for 21 days it capture his RHB @ 160 bmp..several times 17 pages worth. Did an EP Study on Monday (5/9/11) however the Dr couldnt get the heart to speed up. Per the monitor it appears to be coming from the upper chambers; but they cant find the problem. What should we do next? He has astma...was in marching band and overall healthy. [/INST] Hi, So the problem is rapid heart beating. Try to find out if its physiological or related with other diseases like anemia, hyperthyroidism, pheochromocytoma, fever, other high output state, COLD, Bronchial asthma on bronchodilators. To rule out cardiac cause as primary reason after ruling out valvular heart disease by 2D Echocardiography and Doppler study, not diagnosed with EPS. You may consider for 3D mapping, and panic attacks may be the other cause. Hope I have answered your query. Let me know if I can assist you further.  </s>