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Heart Disease (Expert Forum)
holter results, cardiomyopathy
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holter results, cardiomyopathy
by bml, Feb 01, 2006 12:00AM
I recently wore a holter monitor, The results were basic rhythm sinus bradycardia, heart rate range from 41 to 95 with a mean of 59. There were 46003 total beats of which there were 2122 ventricular ectopic beats of which 2049 were single isolated ectopics beats and there were 35 pairs of ectopic beats and one run of 3 ventricular ectopics beats at 77bpm. there was one single supraventricular ectopic beat. I was on on 20mg of lisinopril and 6.25mg of coreg bid. 10 months ago before i was on no medication my holter had a few hundred less ectopics single and couplet but no runs of 3 or more. I'm concerned that I've gotten more of them since i started medication and i question putting the defribultor in if my condition is just going to decline leading to numerous shocks from the defribulator. Other then getting tired from the coreg which has since been upped to 12.5bid I can still walk 4 miles a day and have no sob or other symptoms. Before diagnosis I ran 4 times a week. your thoughts would be appreciated.
Doctor's Answer
by CCF-M.D.-MJM, Feb 01, 2006 12:00AM
Hello,
I understand your concerns. We don’t usually view holter monitor data in that way. As many people on this forum can attest, there are good days and bad days for PVCs – there are even good weeks or months and bad weeks or months. I don’t think 2 24 hour holter monitors indicate that your disease is progressing.
Regarding the defibrillator – an ICD would not concern itself with only three PVCs in a row. Use the Medtronic ICD as an example – you have to have 16 of 18 consecutive beats in the ventricle at a fast rate for the device to recognize the VT and start to charge. After it starts to charge there is an additional 5-8 seconds while it charges for it follow the rhythm and decide to shock or not. PVCs alone will not cause an ICD to shock.
Coreg is shown to decrease ventricular arrhythmias. It is one of the most important medications you can take for a cardiomyopathy. I would not stop it.
I hope this answers your questions. Thanks for posting.
I understand your concerns. We don’t usually view holter monitor data in that way. As many people on this forum can attest, there are good days and bad days for PVCs – there are even good weeks or months and bad weeks or months. I don’t think 2 24 hour holter monitors indicate that your disease is progressing.
Regarding the defibrillator – an ICD would not concern itself with only three PVCs in a row. Use the Medtronic ICD as an example – you have to have 16 of 18 consecutive beats in the ventricle at a fast rate for the device to recognize the VT and start to charge. After it starts to charge there is an additional 5-8 seconds while it charges for it follow the rhythm and decide to shock or not. PVCs alone will not cause an ICD to shock.
Coreg is shown to decrease ventricular arrhythmias. It is one of the most important medications you can take for a cardiomyopathy. I would not stop it.
I hope this answers your questions. Thanks for posting.
Your subject line reads "holter results, cardiomyopathy." Are you taking lisinopril and coreg for CM?
Are you supposed to be getting a debibrillator b/c of the CM?
Were you symptomatic at one time?
Hope you are doing well today : )
connie
I'm always amazed when I hear that people can develop cardiomyopathy (me included) and not have any real symptoms. How did you find out about the CM? Mine was "discoverd" on a routine echo for a leaky mitral valve. Definitely a shocker! Any idea why you ended up with CM?
Just curiors, did you have any difficulty with dizziness when you first started on the lisinopril? It took me about 4 months to adjust to lisinopril. Now, that it is the right dose and I've been on it for over a year, it doesn't bother me at all. Whew!
How does your cardio treat your cardiomyopathy? What's your story, i.e., have you experienced significant symptoms?
I ask because my echo last June revealed mild right ventricle systolic dilation and dysfunction which came to light after my third pregnancy. I was very symptomatic during the last months of my pregnancy, but never enough to warrant hospitalization, bed rest only.
Thanks, and hope you're feeling well.
Carolina
Prior to diagnosis, I didn't notice any symptoms, but a couple of months into the diagnosis, I started to have swelling and was absolutely exhausted. I was very short of breath about 1-2 yrs before the diagnosis, but the cause was never discovered and after several months, the SOB went away. During that time, EF was normal. Somewhere between an echo in January 2002 and December 2002, my EF plumeted and I was diagnosed with CM.
Since the ablations, my BP jumped up above where the doctor wants it to be. Now, I am back to taking an ACE everyday. She mentioned adding a BB, but since BP is good now, mum's the word on taking the BB everyday. I can still take it for symptomatic relief of pvcs, but those days are far and few between now.
Are you taking an ACE and/or a BB? Does your doctor think your CM was related to the pregnancy? Or, was it just coincidental that you were pregnant when it was diagnosed? When is your next echo? I go for echos every 6 months to watch a leaky valve and to be sure the CM does not recur. I had the ablations in 2003 and my last echo in Nov. 05 still showed EF of 60%. Since I didn't have any real symptoms prior to the CM diagnosis,I get pretty nervous when it's time for a check up.
Three kids and bed rest....uh huh : )
Take care and hope you are doing much better.
Connie
I'm sorry I missed your reply! Yes, I'm on an ACE and was ORDERED to start taking a BB last week. I tried it and felt terrible. It really makes me feel tired and ill, but my doctor called again today saying he really wants me on it. I had worn a Holter monitor which revealed some runs of tachycardia and PVC's.
I have echoes about every six months.
Thanks for your reply! And you're right about resting w/ three kids ... NOT!
Carolina :-)