Holter Monitor Results

[bondieluv]

Hello, Doctor...

I am a 44 year old woman who had a holter monitor test for heart palpatations, which I have had for a couple of years but have increased in frequency in the last 6 months.  Here are my results:

General
109769 QRS complexes
0 paced beats (<1%)
2823 Ventricular beats (3%)
4 Supraventricular beats (<%)
0 BB beats (<1%)
0 Junctional beats (<1%)
0 Aberrant beats
0 % of total time in AF/AFL
100 bpm), 12% total
13251 beats in bradycardia (<60 bpm), 20% total
1.36 seconds Max R-R at 05:33:14


Supraventriculars (S.J.A)
4 Isolated
0 couplets
0 bigeminal cycles
0 runs totaling 0 beats

Recommendation from reading cardiologist, "This appears to show recurrent episodes of nonsustained ventricular tachycardia which are symptomatic.  She will require a referral to an arrhythmia specialist and need an echocardiogram to determine her left ventricular function.  In the interim if there is no contraindication to beta blockers, you should consider starting her on 25 mg PO BID"

I am now taking Metroprolol as prescribed, and I must say when I remain calm, it really seems to help, but some days now I am worring myself sick.  I tend to breathe shallow and I do get short of breath with the palpatations.  Seems when I can keep myself calm none of this is an issue - but when it happens I worry which makes it worse - a vicious cycle.  I am an active, busy mother of two and now I seem to stress about this constantly.  I have an appointment for the arrhythmia specialist for June 10th.  Please, can you tell me if I should be this worried? I am very worried - it's some days all I think about.

Thank you.
~Karen

[Michael J. McWilliams, M.D.]

I agree with the recommendations and wording of your cardiologist.  It is probably nothing to worry about, but there are additional tests like an echocardiogram that will help determine if there are any risks.  The most important information that is needed is if you have a structurally normal heart  -- the echo will answer that.

If your cardiologist was worried, he would have called the arrhythmia doc and scheduled you the next day or admitted you to the hospital.  The fact that they didn't do these things suggests that they think you are low risk.

[bondieluv]

Ventriculars (V.F.E.I)
2460 Isolated
7 Couplets
4 Bigeminal cycles
66 runs totalling 349 beats
14 beats longest run 173 bpm
4 beats fastest run 196 bpm

Heart rates
44 minimum at 01:47:59
76 average
141 maximum at 14:12
13251 beats in tachycardia
22099 beats in bradycardia (<60 bpm)
1.36 seconds max R-R at 05:33:14

[bondieluv]

To: correction
...okay I am not sure why this is cutting of my typing...

13251 beats in tachycardia (>100 bpm), 12% total
22099 beats in bradycardia (<60 bpm), 20% total
1.36 seconds maximum R-R at 05:33:14

(now you should have it all...   )

[finetilthree]

it is cutting off your typing because there is a character limit to what you are typing.  all of your spaces are counting in that count.  you are wasting alot of your typing space with all of that blank space.  if you have to post again, try posting more like sentences and less columns!  Good Luck! Check out the community forum also!

[bondieluv]

Thank you for your replies.  As I'm sure you understand, Dr. McWilliams, it's hard being the patient and not understanding what the cardiologist sees when he reads the results - and yet carrying the heart in question.
~K

[upbeat633]

Could you not ask the doctor who had you do the holter monitor for the echocardiogram in advance of your appointment with the specialist?

That would answer a lot of questions for you and may help to put your mind at ease until you see the specialist. As the doctor here suggested the most important point is to discover if you have a "structurally normal" heart, in that case the extra beats are considered benign (to them at least lol).

Are you outside the U.S or on a managed health care plan where you have to wait or follow certain referral quidelines to get that echocardiogram?

[bondieluv]

Hello!  I am in Canada, and I have to wait for "next available" to get the echocardiogram.  I would love to be able to get that done before I see the specialist.

I had a EKG stress test (treadmill test) about 3 years ago for palps and they disappeared with exercise, re-appeared upon recovery, and that cardiologist told me "you are fine, you will live to 100" - I was SO relieved when he said that, I've never forgotten how I felt when he said that (that cardiologist retired, I'm with a new cardiologist I've never met), and I pray I hear the same thing again after this round of testing...I've never had an echocardiogram before.

Thanks for your reply!

[pvcchick]

Just out of curiousity which Province in Canada.  I live in Alberta and they are opening up a special heart hospital in Edmonton that I am looking into.  Funny thing the cardiologist said you would live to be 100.  So did mine.  Wonder if it the same one?

[bondieluv]

Hi there!  I'm in Manitoba, the cardiologist was at the St. Boniface Hospital in Winnipeg.  Do you have on-going issues with PVC's too?

[pvcchick]

Yup, they can't find a thing wrong with me but I sometimes skip all day.  They have seen couplet PVC's triplet PAC's but I am the same as what Upbeat posts.  They always tell me I am normal but I beg to differ.  Those cardiologists must all say the same thing then because I heard the same thing from mine. My PVC issues have been going on for 20 years or so.  PS - Iived in Winnipeg when I was a little girl - I remember a ton of snow!

[bondieluv]

So have you had the holter monitor and echocardiogram and etc?  I really have been nervous lately and waiting is the very hardest thing, not knowing if I should worry as much as I am doing, which of course makes it worse.

We didn't have a lot of snow this year but man was it cold!!! I'm not in Winnipeg, we're about 1 hour away just the other side of Stonewall in a village called Balmoral.  Population maybe 200 on a good day, less when they head out on garage sales!! lol

[pvcchick]

Had it all Bondieluv.  Had holters, echos, stress test - you name it I have had it.  They can't find a thing wrong with me.  They say everyone gets these things and to not worry about it.  I have had them for over 20 years and still cannot get used to them.  They just feel so awful even if they are benign.  Believe me, worry makes them 10 times worse.  I can actually make myself have them just by thinking about them and stressing.  

You are probably in the same boat as the rest of us and they will just tell you - benign, benign.  I am so sick of hearing it.  I guess we just have to somehow, someway learn to accept them.  I actually say that since I have been on the Prozac my anxiety level has gone down tremondously about them.  

If you have had the holter and they didn't call you right away about it then you are I am sure fine.  I had an 8 beat run of NSVT that they called me in to the hospital for on my first holter and that is when they did all the tests on my heart and said it is fine.  I had returned the holter at 2:00 p.m. on a Wednesday and the emergency department called me at 9:00 a.m. the next day so they don't make you wait if it something serious.

[bondieluv]

Thank you, what you wrote is very, very reassuring - and yes, stressing out about these things does make them a million times worse.  During my holter monitor test, I was at about hour 22 and nothing significant had happened, and I started stressing about oh no, what if this thing doesn't pick anything up - and WHAMO all of it went off, the palps, runs, lightheadedness, shortness of breath, just like a party for an hour - so I knew for sure they got all I could give them to look at...

What scares me is that these last PVC's etc have become "symptomatic", I do get the breathlessness mostly but that's new in the last 6 months or so.

I so would love to hear benign.  Would do about anything to hear that right about now!  

[upbeat633]

I used to live in Canada. I can't believe the wait times now for most things there. 15 years ago, after struggling with pvcs for years previous, I saw a very sympathic and understanding family physi