Holter Report

I just received my holter report and a letter from my doctor stating that there were abnormalities and I need to schedule a follow up.  Does anyone know what the following information means:

Summary:

The total recording time was:  24:00 hours.  Total Beats = 108544.
Heart Rate:  MAX = 135 at 7:17 AM(2), MIN = 49 at 5:47:26 AM(2), AVG = 70
There were 0 pause(s) > 2.0 seconds

VENTRICULAR SUMMARY                  SUPRAVENTRICULAR SUMMARY
Total       :  297                                                    Total           :    33
Isolated   :  297                                                    Isolated       :    11
                                                                           Runs          :      4
                                                                           Run Beats  :      20

Longest:  SVE run = 6 beats at 2:57:53 PM (1)
Fastest:  SVE run = 189 BPM at 2:57:53 PM (1)

1) The quality of the tracking was fair/poor.  The basic rhythm was sinus.  During this time her average hear rate (HR) was 79, with a min. HR of 49 at 5:47:26 AM(2) and a max. HR of 135 at 7:17:58 AM(2).  The PR interval measured .15 sec., the QRS .09 sec., and the QT measured .31-.44 sec.

2) 297 isolated vetricular ectopic beats.

3) 33 supraventricular ectope beats, 1 paired beat, and 4 supraventricular runs with the longest being 6 beats @ 2:57PM

Thanks to anyone who has any info.

[surfgirl]

which part don't you understand?  It seems pretty self explanatory to me.

[Kate18]

I have no idea what normal ranges are, so I have no idea if these fall within normal ranges or not.  Do you know what the normal ranges are?

[pvcqueen]

That depends....you need to speak to your doctor.

[Awake and Unafraid]

Self explanatory?  Not to someone who doesn't know what the numbers mean.  I have no idea what this means but she is understandably worried.  Do you know what the numbers mean.  If so, please enlighten us.

[FLBrat]

I dont try to understand the numbers until the doctor and I talk.  There are usually other factors to be discussed and trying to read these can cause more stress.  Other factors are your general health, meds taken, family history, heck, even your job can affect the health.

Call for the appointment.  Make sure they know when you schedule that the dr said there was abnormalities and you need ASAP scheduling, to put you on the list to call if there is a cancellation.  You are in no worse shape than the day before you got the letter, the difference is that you have heard the word abnormal.  If there were gross abnormalities I am sure the dr would have recalled you to the hospital.

[heartfluttersflyawayplz]

go post this on heart rhythm, they will be able to help you out. its the forum right under this one.

[FLBrat]

Unless you see the medical liscense, remember ANY forum is not going to be able to answer the questions your doctor can.  They may help explain what your doctor means, but that is all.  Remember, they do not know all the factors you and your doctor do.  

[Momto3]

I can help a little. If this is the first time you have had a chance to see one of these reports, they can be a bit "complicated."  However, I'll try to break it down so you can at least get the general idea.  First, from my point of view (I'm not a doctor), I don't see anything alarming in the report.  There are a few "events" that your doctor probably wants to talk to you about.  Here is what I can tell you:

During a 24 hour period, you had 108,544 heartbeats (a good thing)
During that time, your maximum heartrate was 135 (HR usually avg 60-100)  Heart rate should increase during physical activity, or sometimes it just accelerates on its own (not great, but can also be a normal variant).  It is very normal to have your HR increase when you are walking, running, etc.  A lower HR tends to occur during sleep.  Do worry about the 49; it was at 5:47 a.m.
Your average HR during the entire 24 hours was 70 (Excellent)

The "ventricular summary" summarizes the "abnormal" beats that originated from your heart's lower chambers (the ventricles).  In your case, you had 297 extra (sometimes called ectopic) beats.  All of the extra beats were isolated or occurring one at a time.  This is very, very common, nothing to worry about.

The "supraventricular summary" is to summarize all of the "abnormal" events that originated in your heart's upper chambers (the atria).  In your case, you had a total of 33 extra beats.  There were 11 isolated extra beats and 4 runs (a run is when you have 3 or more extra beats in a row).  The longest run was 6 beats at 2:57 in the afternoon, also the fastest (your HR was at 189 beats per minute).  This is probably the part the doctor wants to discuss with you.  He'll likely ask you how you were feeling, what you were doing, etc.  He may want to order an echo to be sure your heart muscle is structurally normal.  While these are abnormal events, they are also very common.  In a structurally normal heart, they are generally not harmful.  This is what the doctor will determine.

Basic "sinus" rhythm is normal. The PR, QRS and QT measurements have to do with the EKG readings.  That gets a little complicated, so I won't attempt to interpret that...lol

Good luck with the upcoming appointment.  

connie

[Awake and Unafraid]

Wow Connie!  Thank you for taking the time to break this down for those of us who do not understand.  It is clear in Kate's post that she is worried and justifiably so when you don't know the numbers and get a note from your doc to come in.  Sometimes all we need is a little reassurance and you took the time to do that.  Thanks.

Penny
(Mom to 4) (boys!!!)

[surfgirl]

You are very patient...........the ultimate responsibility is with the doctor to correlate the clinical picture.  I hope I did not sound too abrupt.

[Momto3]

Penny,

I could also "hear" the fear in Kate's post....I agree, it is definitely not "self-explanatory" to most people.  Unless you have some medical background, or if you have been there, done that (in my case), this is like reading Greek (for those of us who don't know Greek...lol).

4 boys!!  COOL!!!  My 3 are grown, and I now have a son-in-law, so I guess I'm sorta momto4 now : )

Have a great day!!
Connie

[often]

Personally, if I get a call or letter telling me I need to come in for a followup, I call the doctor's office and request (or demand, if that is what is needed) to talk to a nurse and find out what is going on.  I refuse to give a message and will hold until she/he (or the doctor) is available.  I know it is annoying and scary, but hey...think about it.  If it was something MAJOR, you would not have gotten a letter...you would have gotten the call.  Since it is invariably a Friday that the call comes (yes...I get calls, not letters), I always forward my home phone to my cell on the Fridays after any tests I have.  OH but then if it is REALLY serious, they call me at work.

[pvcqueen]

  I  hope you don't take offense. You have a way of trivializing people's concerns that is not supportive or constructive.

[Momto3]

I agree, the ultimate responsibility is with the doctor and as for "correlating the clinical picture," I'll sit that one out....lol.  I just figure since I've dealt with arrythmias for over 30 years, I can help explain some of the terminology.  I've dealt with doctors who give book diagnoses and offer little in the way of patient comfort.  I've also dealt with kind and compassionate doctors who know that some patients prefer to understand their symptoms/condition.  As you might have guessed, I prefer a physician who takes a little extra time to clarify medical terminology and such.  On the other hand, I know plenty of people who prefer the cut and dry approach, just not for me.

To that end, I'm not sure if I am patient, but I do know what it is like to be a patient looking for clarification.  Fortunately, there have been many people along my journey that have helped me, so if I can do the same, why not.

Too abrupt?  

[tickertock]

What did your doc/cardio tell you about the holter report? The longest run was only 6 beats a salvo of SVT or run of PACs, this is a fairly common finding and unless this is sustained , the holter would probably be termed "essentially normal". If you have symptomatic prolonged palpitations then you could have a repeat, if your doctor is not concerned then you shouldn't be , if in doubt always seek a 2nd opinion.

[Momto3]

"Do worry about the 49; it was at 5:47 a.m."

In my post to Kate above, I meant to say..."DON'T worry about the 49........."

Sorry about that.
connie

[viennaustria]

See, this is why we should let the Dr to read and to explain reports like that. Do worry OR don’t worry what a big different giving it to people. They already might suffer in anxiety, confusion; you might do more harm then good.

[pvcqueen]

the PR QRS and QT are all normal.

[pvcqueen]

I see you are on your high horse again.......I heard all about you and how you and that Surfgirl like to make trouble, but I am not going along with it.  She was only trying to help, and in the whole context of things, you could tell what she meant.

[Momto3]

The Patient to Patient Forums provide a place for the public to "interact with people with a shared interest in a particular medical topic."  The discussions are not meant to take the place of one's own physician's diagnosis and/or advice.  I do not portray myself as a medical professional and in fact, state clearly that I am not a doctor.  The patient-to-patient heart forum is a place for questions, answers, information, diaglogue, support and whatever else it offers to its readers. We are literate adults who understand that these discussions are NOT medical advice.  As a participant, I merely offer my personal interpretations and experiences with the intention of helping others understand and feel comfortable with discussing personal situations with their own physicians.

We all make typos, you, me, and the doctors.  

[surfgirl]

Doctors Never make typos............never.  Didn't you know that?  Heck, they don't even type.

[Momto3]

Good one!!  You made my day : )

[viennaustria]

"We all make typos, you, me, and the doctors. " EXATLY....see this is my point too.
I would never write my full report here and ask people (other patient like myself, to interpret .It would  be damn from me.) :) So it was a damn question on the first place.
  Surfgirl who is as a nurse a medical professional didn't answer. Good for her. Certain posts while should get a recognition, sympathy, what ever, but playing DR because we have the condition is not right in my humbled opinion. All posters should know where is the tin line not to go over it, but tell the OP kindly to go to his/her Dr. as Often and Brat even PVC queen suggested very wisely.


  for PVC queen
  From the high horse one can have a better view.:)

[Thatch]

It looks like the only time there was something that was out of the ordinary enough to be slightly concerned was a single episode which lasted just under 2 seconds at around 3 in the afternoon. Maybe something scared while you were driving or you almost dropped something.  If I had a Holter like that I would be ecstatic. You want to find out what is going on but there is no need to worry.
The tests that can be done these days are amazing. One word of advice is that if it is decided that a nucleur stress test is going to be done is to take a button up sweater with you to put over your shoulders so that the AC doesn't chill you too much if you have to sit around after they put the little pads on you. I got really cold.
Echos are kind of fun because you can watch the screen and see you valves open and close and during one part you can even listen to the blood being pumped. It is kind of fun.

Thatch

[Momto3]

Although I had some difficulty in deciphering what you wrote, I will reconsider how I respond to posts in the future.  

I prefer to walk than ride high upon the tallest horse.  That way, when I fall it doesn't hurt so much : )

[Momto3]

I love watching the valves open and close....  I don't know much about what's on the screen, but I can pick out all four chambers and see the valves!  That's so cool!

[viennaustria]

Tolerate the pain ennobles the character .

[Kate18]

Thanks everyone.  Momto3 you were ESPECIALLY helpful in helping me relax a bit.

I have had the follow up and though there are abnormalities AND the fact that I am on thyroid medication, he wants to try a couple of things with the thyroid meds to see if they are causing some of the issues.

Thanks again, I had no idea what the numbers meant, I heard the word "abnormal" and it was a weekend!!!!!!!!  I freaked out.  I had called the nurse, but they said they really couldn't tell me anything until I spoke with the doctor . . . which freaked me out more.

Again . . . THANKS EVERYONE!!!!!!!!!!!!!

[Momto3]

You're very welcome!  I know exactly how those phone calls, letters, reports can RUIN a perfectly good weekend : )

Take care, you're on your way to feeling great!  Be well and keep us posted.

connie