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Holter Report Summary Help
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Holter Report Summary Help

My PCP handed me my Holter report today and just said, "make an appointment with a specialist in electrophysiology".  So now I am a little concerned and it is causing me anxiety, my appointment with the specialist is 8 days away.  Here are the results of my monitor:

Total QRS Complexes:  113563
Ventricular Ectopics:  53
Supraventricular Ectopics:  13
Heart Rate:
     Min:  53
     Max:  135
     Avg:  82
Rate>= 135 bpm for 10:46
Rate<= 50 bpm for 00:00
Pause:  14
Longest 9.3 secs

Ventricular Events
Isolateds:  42
In Bigeminal Cycles:  0
Couplets:  4
Runs:  1
Longest:  3 beats, 97 bpm

Supraventricular Events
Isolateds:  3
Couplets:  5
Runs:  0

No ST Depression or St Elevation

I am 32 years old, female.  Echo, stress test, chest x-ray, and bloodwork have all been normal.  I do feel 2 - 10 fluttering heart palpitations a day and it feels like someone is sitting on my chest when they happen.  So far no fainting.
Avatar_dr_m_tn
Hello. The fact that you had a complete cardiac work up that was normal (echocardiogram and stress test) is reassuring. The symptoms that you are having are most likely related to the ventricular ectopic complexes or PVCs. A high percentage of the population has PVCs during the day, but is hard to define why only some of the patients can feel them. It is presumed that this is related to an increased awareness of the arrhythmia and stress. Usually the PVCs come from spot in the heart's ventricle that acts as an extra pacemaker and that can cause a change in the sequence of our normal pacemaker (sinus node). The activity of the extra pacemaker may be increased by different factors like stress, hormones and medications. Now why can we feel these extra beats? Just because the strength of every heart beat depends on the amount of blood that fill the heart before the next contraction. Every time that you have an extra beat, the normal pacemaker makes a pause to regain its normal rhythm, and that's when the chambers get filled with more blood. So the beat that you feel is not the PVC, is the beat that come after that one that is usually stronger. Symptoms that are red flags w/ PVCs are sustained PVCs (i.e. sustained or non-sustained ventricular tachycardia; multifocal PVCs during exercise; or passing out b/o an arrhythmia). In your case, as somebody already told you before, you are extremely sensitive to the PVCs. They can be treated with medications (i.e. beta blockers) or even invasive procedures (ablation) to "burn" this extra pacemaker and make the PVCs disappear.
The other significant finding in your holter is the presence of pauses (your normal pacemaker stops for some seconds). I do not have the report to see it but if those pauses are during the night is usually normal. If you are having them during the day and you feel lightheaded or if you have ever passed out, then it is a different story and you may need other tests.
Good luck
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