Holter Monitor Results - Need Help Understanding

[cindy1960]

Hello again!

I'm 47 years old, in pretty good health (good BP, etc.) and no major health issues. Just PM (peri-menopause) GERD and some overweight.

I'm facing day 11 with steady PCVs.

Today,  I got my Holter Monitor Test results but dont see my Cardio until the 8th.

Can someone please help me to understand these numbers, I greatly appreciate it so much!

HOLTER REPORT SUMMARY:
total QRS complexes = 90090
Vernticular Ectopics 203 (=2.0)
longest 3.6 secs at 8:19PM (this is odd too)

VENTRICULAR EVENTS:
isolated 197
bigemnal cycles 0
couplets 3
runs 0

SupraVernticular EVENTS:
isoltated: 793
couplets 543 (seems like a lot!)
runs 213 (also seems like a high number!)

Please if anyone knows what these numbers mean, please let me know, I'm going nuts worring and tring to deal with the PVCs each day, its hard and I want to be prepared with whats going on -good or bad.

Thanks again so much!

[cindy1960]

Hi Connie!

yes, this PVC/PAC/SVT stuff is nerve racking to say the least! I'm very thankful for having a great husband and family...but these forums have been a God Send for me, hearing from good people like you that have been there - done that has helped me so much to fully understand.

None of my close family/friends have a clue what I am dealing with, but are very understanding.

My Mom did tell me that about 20 years ago when she was my age, (47-48) she remembers having heart flutters and Daddy taking her to the Doc who said it was harmless flutters brought on by peri-m. She is conviced that is what I am dealing with, I hope thats all it is!

I was really super satisfied with my family doctors care and the wonderul care from the ER but a bit disappointed with the Cardio Doc. I am hoping he will listen to me, really listen and take me serious about wanting an ECHO done. I think when he sees my Holter test that he will be a little more on top of things and not just.... write a script, see ya in 2 weeks, bye!

I read some about the Echo tonight and my step daughter was wondering why they ran test and didnt do that! now I wonder too.... I will ask my fmaily Doc on Monday for some answers. This is a very serious thing for me...it has been so difficult to live.

Today, it got really bad. The skips were harder, lasted longer and more frequent. It puzzles me...how un-predictable they are!!!!!! I think, OK...better when I drink lots of water...nope, that didnt help...better when I stay active....nope that didnt help...and just when you think, OK they have calmed down a little bit, they come back with a vengence! No pattern for me, they are just all over the place when ever they please!

Today was so hard for me....I started to go back to the ER.... I was so tired, S.O.B, and the PVCS/PACS were banging like fire crackers in my chest. Over and over in runs,,,,it was scary.

Last week, it was strong flutters with breaks in between. Maybe 2 in a row and not another one for several minutes.......so I had time to catch my breath and deal in between the skips.

But today, for a few hours, it was flutter - flutter- skip - beat...beat...skip..beat...beat...beat...flutter flutter..skip. It was like a war zone in my heart!!! with the pounding heart beats plus the pops, flutters and skips, it was like snap, krackle, pop in my heart!

I became so very tired, I layed down and tryed to take deep breathes, it finally stopped then just the routine PVCs were there...I was so thankful that I didnt have to be anywhere today.

Wonder if that happens to other people? Seems awful tiresome to me...how can a Doctor, any Doctor expect a person to live like this?

Thanks again Connie! oh yea, I will check out the profile page too!

[Momto3]

Hi Cindy1960!!  You're very welcome; I'm glad I was able to help a little.

No,an echocardiogram is not the same thing as an EKG.  An echocardiogram is an ultrasound of the heart.  It helps determine the heart's overall functional capacity, tells about the valves, chambers and wall motion.  It's possible that the ER doctor did not feel it was necessary based on your overall exam.  I'm a little surprised the cardio didn't run the test just because it seems that it's a fairly typical test under the circumstances.  Perhaps, he too, thought it unnecessary.

Generally, when I've heard the phrase "structurally normal heart" it's said after an echo.  But, like I said, maybe both doctors had enough information to determine your heart is healthy.  You might want to ask how they know your heart is structurally normal?

For me, I'd just want an understanding of what was/is going on.  As for how many beats in the runs, it would just clarify what's going on.  Here's the part about the structurally normal heart again...The doctors usually let us know that under healthy circumstancs, the extra beats are more an annoyance than a problem.  It bugs me that the Cardio blew in and out of the room so quickly...GRRR!  When a patient is concerned over something, why not take the necessary time to explain and be sure the patient has a good understanding?  Fortunately, many doctors follow that protocal, but not all of them.  My guess is that he may offer you the toporol again, but it's not for certain.  ROME??  WOW!  The 8th is not too far off and maybe he'll spend a little more time with you.  Just to be sure the cardio is cool with the 40 bpm reading, I'd run it by him. Be sure to ask him about taking a medication that could further lower your heart rate.  Better to ask than to wonder.  He may not be as alarmed b/c he makes a living out of dealing with this type of situation and also he has the report in its entirety and will be able to clarify any isolated events.  If the extra beats bother you, be sure to let the doctor know.  He may prescribe a beta blocker or he may have you try and "live with it."  As long as you know they will not hurt you, it may just be a matter of reassurance.

I hear ya on the periM!!  I've had PVC's since my late teens and every now and again they result in what I call "storms."  My early 40's was one of those times!!  I have enough on my plate, thank you very much..lol.  I had my ablations when I was 46!  My electrophysiologist agrees that hormones can, and do, play a role for many women.

Hey, welcome aboard!  You'll be in great company on this forum; we get it : )  It's nice to hear that your hubby is supportive; that really helps.  PVC's are such a weird thing to explain if you've never felt them.  My husband asks what it feel like and do I think he has them.  When he would listen to my heartbeat when it was out of whack, he thought it was soooo weird.  He was right : )

Have you thought about adding a profile (see above link)?  If you decide to do that, you can make it ias vague or as forthright as you choose.  Those who have profiles have screen names in blue.  We can send messages to one another as well as a host of other extra things to help make the forum more beneficial to us.  You don't have to have a profile, but you might want to take a look at the benefits.  Hope you're having a great day!   The 8th is right around the corner : )  We'll be here to get you through the waiting period.  Make it a great day!
connie

[cindy1960]

Hi Momto3!!!! Thank you so much for breaking that down for me...reading what you wrote, it totally clicked with me, I was like, oh ok..I get it now! Thank you!!!!

Your questions: I'm not positive and I am not a doctor, but I don't see anything alarming on your report.  Have you had an echocardiogram?  is that the same as an EKG? I did have an EKG last Friday when I went to the ER thinking I was dying!

Do you have a structurally normal heart?  Both the ER Doc and the Cardio Doc said my heart was nornal and healthy, does that mean the same as structurally normal? Should I request a test to confrim that?

The one thing I would want clarification on is the length of the runs (how many beats).    What does your doctor say about the extra beats? the runs?  If he/she is not concerned, you may still be offered a beta blocker to help with the symptoms............The ER Doc was pretty cool about it, not alarmed, said it was all normal PVCs, but refered me to the Cardio. When I saw the Cardio, he was wam-bam! in and out so fast! he went over everything that the ER had sent him and wanted to place me on Tropol XL. and see me in 2 weeks, then he said he really did want to see the holter monitor results. they results didnt get to him until yesterday! and now...he is in ROME on vacation, so I have to wait until the 8th to see what he thinks about the holter results. My family Doc got the results and called me, she was mainly concerned of the 40 BPM during sleep and that I need a sleep apnea test and she wasnt too concerned with the PVC results either.

Incidentally, extra beats sometimes come on as a result of hormonal changes like those that occur with pregnancy, periods, periM, etc.  I am FULL BLOWN periM and the family Doc is convinced that that is what it is. she also stated to hold off on the beta blocker, she didnt want my heart to slow down any more...after reading the 40 bpm during sleep. But, I have no symptoms of sleep apnea and I really dont think thats the problem.

Hope that helps a little.  Momto3, this has help soooo very much!!!!!!!!!!!!
Thank you for posting. I know that I will probably be on her often, whining about this, it will be 2 weeks on Monday and its really bad. My Hubby is WONDERFUL! but he has no clue what a PVC is ro feels like but supportive.

I'm thankful for great folks like you, that can relate and are kind to share your thoughts and experiences. It means alot to me and helps so much! Thanks again!

[Momto3]

Hi Cindy,

I can relate to the frustration of living with PVC's.  Here's my take (I'm not a doctor, just a fellow patient) on your report:

During the monitoring time, you had a total of 90,090 heart beats.  During that same time, you had 203 ventricular ectopics (PVC's), the longest lasting 3.6 seconds at 8:19 in the evening.

Of the 203 ventricular events, you had 197 isolated (single) PVC's and 3 couplets (2 PVC's in a row, with no normal beats in between).

As for your supraventricular events (above the ventricles), you had 793 isolated premature atrial contractions (PAC's) and 543 couplets (2 PAC's in a row, with not normal beats in between).  There were also 213 runs recorded (a run is considered 3 or more ectopics in a row, with no normal beats in between).

During the test, your lowest recorded HR was 40 at 05:06am (as you said, in a deep sleep) and normal during rest.

Your maximum HR was 174 bpm at 3:50pm.  This may have been during one of the PAC runs.

Your average HR, during the testing period, was 73 bpm.  There were 66 pauses of what appears to be greater than, or equal to, 2 seconds, the longest being 3.6 seconds at 8:19 pm

I'm not positive and I am not a doctor, but I don't see anything alarming on your report.  Have you had an echocardiogram?  Do you have a structurally normal heart?  The one thing I would want clarification on is the length of the runs (how many beats).    What does your doctor say about the extra beats? the runs?  If he/she is not concerned, you may still be offered a beta blocker to help with the symptoms.   Incidentally, extra beats sometimes come on as a result of hormonal changes like those that occur with pregnancy, periods, periM, etc.  Hope that helps a little.  Maybe some of the other members will come along and give their opinions.  Just remember, we're not doctors, just people who have been through some of this stuff.  Have a good night.

[cindy1960]

HEART RATE:
min: 40 bpm at 05:06am (in a deep sleep)
max: 174 bpm 3:50pm (this sounds odd to me)
avg: 73 bpm

pause 66 pauses (>=2.0)
longest 3.6 secs at 8:19PM (this is odd too)

[cindy1960]

REVISED: (left out the bpm)

Can someone please help me to understand these numbers, I greatly appreciate it so much!

HOLTER REPORT SUMMARY:
total QRS complexes = 90090
Vernticular Ectopics 203 (=2.0)
longest 3.6 secs at 8:19PM (this is odd too)

VENTRICULAR EVENTS:
isolated 197
bigemnal cycles 0
couplets 3
runs 0

SupraVernticular EVENTS:
isoltated: 793
couplets 543 (seems like a lot!)
runs 213 (also seems like a high number!)

Please if anyone knows what these numbers mean, please let me know, I'm going nuts worring and tring to deal with the PVCs each day, its hard and I want to be prepared with whats going on -good or bad.

Thanks again so much!