Holter Results and Tachycardia

2 weeks ago had a tach episode (started in the night and continued next day, with periods of HR under 100, so, not continuous). Went to health center ER were they run an EKG and the HR was 150bpm. The Dr. said that seemed SVT and sent me to Hospital ER. In the Hospital they monitorized my heart (TV continuos EKG)all afternoon and said that the tach reverted. In Hospital said also, neither there, neither in the EKG chart made in HCenter I was with SV rythm but only sinus. Later my GP confirmed that was only sinus tach.
Q 1 - In EKG how SVT is shown (rather then simple sinus tach)?-Shouldn't any Dr. know that?
Did an Holter some days ago - Results: Good technical conditions. HR between 53 and 121 bpm with average of 72 (HR<=50 for 0H 0m/HR>=120 for 0H 1m). 2 isolated ventricular ectopics (no symptoms) and no supraventricular events.Without other arryhtmias. No value alteration of ventricular repolarization. Without symptoms in all exam.
Q 2- Is the 2 ventricular ectopics the same as PVC ? - Is it normal/harmless or could mean some kind of cardiac disease?
Q 3- Is this Holter fine/benign?
Q 4 - Since tach episode was caught in EKG, I think an event monitor is not needed. What's your opinion?
Q 5 - I'm 37 y o man. BMI = 22,5. BP now controled without meds. Did an echocard. 2 y ago and annual checkup (EKG, blood and urine tests, etc.)that are fine. Going to cardiologist next week - Is further tests needed? - What kind (stress test, another echocard.)?
Q 6 - Do prognostics seem good or bad ? Could any healthy (heart) person have these episodes and are nothing to worry?

[CCF-M.D.-KE]

Dear Jose,

Sorry to hear about your recent episodes of palpitations.
1. SVT (supraventricular tachycardia) is a very broad term which includes all heart rhythms over 100 beats per minute  originating above the ventricles (including sinus tachycardia). I am not sure what rhythm your heart was in when you experienced the palpitations. Therefore, I would recommend taking all of your test results to a cardiologist, for further evaluation. I would be sure to include the initial electrocardiogram (ECG) with the heart rate of 150 beats per minute. (You have an appointment next week)

2. Ventricular ectopics  are PVCs which are premature ventricular contractions. In the setting of a structurally normal heart, PVCs are not indicative of a poor prognosis.

3. You have described a HR ranging from 53 to 121 beats per minute and 2 ectopic beats. This does not sound particularly worrisome, most normal people would probably have a similar result.

4. You may need an event monitor, but I think the evaluation by a cardiologist should be the next step.

5. Your cardiologist may want other diagnostic tests, such as an echocardiogram or a stress test. I think this is reasonable

6. Before being able to comment on a prognosis we need a diagnosis. However, if this is SVT the prognosis is good.
Hope everything turns out well.

Thanks for your question,

CCF-ME-KE

[josemanuelcruz]

Dear Dr.,
Just to add information about Holter test: The rythm was sinus.
When the HR was at 121 bpm (1 min.) I just finished getting upstairs to a high third floor (My apartment don't have ascensors)
Thanks