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SVT only 4 times.. but almost 900 beats .. please explain
Hey,
So went back to cardio yesteday.. was talking to her and she is putting me on 2 doses of the beta blocker, 1 in the am 1 in the pm before bed.
When I was talking to her I asked something like... "I read in the 24 hour monitor reprot that I only had 4 SVT episodes.. That's not that bad right?" She said something like, "Oh no, it is pretty bad as you ONLY had 4 runs BUT those 4 runs were almost 900 beats" or something like that..
So what does this mean?
How long is 900 beats(in time)? Why does this make my case different as she says?
Cardio says she really wants to get me on just beta blockers as if she has to move to special arrhythmia meds they had possible serious side effects and blood work needs to be monitored all the time to check for liver and kidney damage or something like that.
So went back to cardio yesteday.. was talking to her and she is putting me on 2 doses of the beta blocker, 1 in the am 1 in the pm before bed.
When I was talking to her I asked something like... "I read in the 24 hour monitor reprot that I only had 4 SVT episodes.. That's not that bad right?" She said something like, "Oh no, it is pretty bad as you ONLY had 4 runs BUT those 4 runs were almost 900 beats" or something like that..
So what does this mean?
How long is 900 beats(in time)? Why does this make my case different as she says?
Cardio says she really wants to get me on just beta blockers as if she has to move to special arrhythmia meds they had possible serious side effects and blood work needs to be monitored all the time to check for liver and kidney damage or something like that.
Well, I wrote a response but some one ate it. LOL Guess I'll keep it short this time and say thanks for the explanation.
Hi!
This is confusing, and even more confusing in my language. We don't use the words PAC and PVC, we say SVES (supraventricular extrasystole) and VES (ventricular extrasystole).
To the more confusing part, a PAC is a SVES but a SVES isn't necessarily a PAC. It may also be a PJC (junctional extrasystole).
Regarding supraventricular tachycardias, they may be lines of PACs but also lines of PJCs (the most common one, nodal reentry tachycardia is a line of PJCs, not PACs).
Anyway, SVE refer to any "abnormal" heart beat that origin above the ventricles. The Holter algorithm for differing them from normal sinus beats is actually just the timing. I think a heart beat that has more than 30% reduced coupling interval from the previous beat is considered an SVE. In tachycardia runs, I think they just count the amount of following rapid heart beats.
This is of course easier with PVCs because they are wider than normal beats, so every wide beat is counted as a PVC (or VE, ventricular ectopy), but this is also problematic, because PACs often manifest with wide complexes (the so-called Ashman phenomenon). Result is, Holter monitors often over-estimate the amount of PVCs and underestimate PACs. In addition, some early sinus beats (when inhaling, for example) is counted as PACs and some late PACs are counted as sinus beats.
This is not easy :(
This is confusing, and even more confusing in my language. We don't use the words PAC and PVC, we say SVES (supraventricular extrasystole) and VES (ventricular extrasystole).
To the more confusing part, a PAC is a SVES but a SVES isn't necessarily a PAC. It may also be a PJC (junctional extrasystole).
Regarding supraventricular tachycardias, they may be lines of PACs but also lines of PJCs (the most common one, nodal reentry tachycardia is a line of PJCs, not PACs).
Anyway, SVE refer to any "abnormal" heart beat that origin above the ventricles. The Holter algorithm for differing them from normal sinus beats is actually just the timing. I think a heart beat that has more than 30% reduced coupling interval from the previous beat is considered an SVE. In tachycardia runs, I think they just count the amount of following rapid heart beats.
This is of course easier with PVCs because they are wider than normal beats, so every wide beat is counted as a PVC (or VE, ventricular ectopy), but this is also problematic, because PACs often manifest with wide complexes (the so-called Ashman phenomenon). Result is, Holter monitors often over-estimate the amount of PVCs and underestimate PACs. In addition, some early sinus beats (when inhaling, for example) is counted as PACs and some late PACs are counted as sinus beats.
This is not easy :(
I assumed (dangerous to do) when SVE mentioned "ectopy" that it referred to ectopics which are typically premature beats. I figured they were different than regular tachycardia. Even this old dog needs to learn some new things.
I don't think any type of SVT/SVE is totally normal but it's not necessarily dangerous either. That's what the doctor needs to decide and let you know. I've had SVT/PSVT and bunches of ectopics (heart hiccups lol) most of my life and I'm doing fine. Based on the run of 377 beats, it would have lasted almost 2 1/2 minutes. You would have felt it but it's not that fast. Many people get their heart rate up that high during exercise.
You may have a good point about the low blood pressure. It would be nice to find out what's causing that. When I was taking my heart med, my systolic BP would drop into the 90's and I felt terrible - so tired and woozy. If yours is dropping into the 80's, no wonder you feel terrible. But I can't imagine that a heart rate in the 150's would affect you so strongly. Hmmm.
You may have a good point about the low blood pressure. It would be nice to find out what's causing that. When I was taking my heart med, my systolic BP would drop into the 90's and I felt terrible - so tired and woozy. If yours is dropping into the 80's, no wonder you feel terrible. But I can't imagine that a heart rate in the 150's would affect you so strongly. Hmmm.
I'm just not understanding.. LOL
a SVE RUN of 377 beats @ 152 bpm is nothing right? It's not a major issue, nothing to worry about, is normal right?
a SVE RUN of 377 beats @ 152 bpm is nothing right? It's not a major issue, nothing to worry about, is normal right?
Hi :) Thanks!
SVE = supraventricular ectopy, but that's just a count of beats. A SVT run of say 100 beats is counted as 100 SVE. But so are 100 single PACs so you can't judge just from that number. The number is usually divided into singles, couplets, triplets and runs, though.
SVE = supraventricular ectopy, but that's just a count of beats. A SVT run of say 100 beats is counted as 100 SVE. But so are 100 single PACs so you can't judge just from that number. The number is usually divided into singles, couplets, triplets and runs, though.
Oh and just noticed where it say SVT, it says frequent runs.. so why does it not give more info of that? when I go back in 2 weeks maybe I will ask if they can print me the full report?
I have no idea ireneo, to be honest I am more out of breath and dizzy I think when the heart rate goes fast? and I get the almost fainting when my blood pressure drops to low.. not 100% sure though...but that is what I think but I feel the cardio is not listening to me about my blood pressure dropping low as when I'm in office(NERVOUS) it is pretty average.. I think like 133/82 last time.. so I just feel she is not believing me when I tell her it is dropping to as low as 80/50ish at times and this is when I feel SO dizzy and faint.
Here I scanned it in for you, yes it says SVE.. is that different? It does say SVT in the comments box.. so the same right?
pic here:
http://www.medhelp.org/user_photos/show/206286?personal_page_id=40033
(does that link work?)
Here I scanned it in for you, yes it says SVE.. is that different? It does say SVT in the comments box.. so the same right?
pic here:
http://www.medhelp.org/user_photos/show/206286?personal_page_id=40033
(does that link work?)
This is getting more interesting.
Is_something_wrong: it's nice to know we're on the same page, where ever that may be.
Lisa: you make me smile. I like your brain just the way it is. You made me think of it all from a different angle.
Candi: thanks for the added information. But your report says "SVE?" Isn't that supra ventricular ectopy? That's different than having a burst of tachy. And 152 bpm is my slowest rate. I wonder why you feel so faint when it happens? Ah, more questions, not answers.
Is_something_wrong: it's nice to know we're on the same page, where ever that may be.
Lisa: you make me smile. I like your brain just the way it is. You made me think of it all from a different angle.
Candi: thanks for the added information. But your report says "SVE?" Isn't that supra ventricular ectopy? That's different than having a burst of tachy. And 152 bpm is my slowest rate. I wonder why you feel so faint when it happens? Ah, more questions, not answers.
Well, with fastest SVT run 152 bpm this doesn't sound dangerous.
I really don't understand the Holter monitorings in the US. Here, we don't get sheets like that, it's all interpreted by a cardiologist who examines every arrhythmia and then draws a conclusion that we are presented at a consultation.
I think that's far more informative. For instance, a cardiologist can differ a wide complex PAC from a PVC. When they are interpreted by the software, every wide complex beat is a PVC.
Maybe you should ask him what SVT you had. When computer interpreted like that, it may be sinus tachycardia for all you know. I had lots of sinus tachycardia runs on my report that were reported as SVT, what happened was that I tried to provoke an arrhythmia by sprinting short distances.
I really don't understand the Holter monitorings in the US. Here, we don't get sheets like that, it's all interpreted by a cardiologist who examines every arrhythmia and then draws a conclusion that we are presented at a consultation.
I think that's far more informative. For instance, a cardiologist can differ a wide complex PAC from a PVC. When they are interpreted by the software, every wide complex beat is a PVC.
Maybe you should ask him what SVT you had. When computer interpreted like that, it may be sinus tachycardia for all you know. I had lots of sinus tachycardia runs on my report that were reported as SVT, what happened was that I tried to provoke an arrhythmia by sprinting short distances.
thanks all.. I think 894 beats TOTAL.. so I just don't think it's bad, right?? I mean why is my dr making big deal about it? And yes I do almost faint at times, but never have actually fainted. I know it's more bothersome then anything, I'm not stressing over it, really I have other things to deal with in my life :) It is what it is and I just want it to be controlled by the meds because I have a little one to take care of and it is bothersome when I to go get it and pick him up and almost fall down because of how dizzy I get.
I only have a 1 page summery of the report which does not says much. It does have this:
Longest SVE run =377 beats, Fastest SVE run = 152bpm.
That is all it days. Does not say what type of SVT, again just a 1 page report.. pretty much just like 1/3 of a page filled with information the rest my name and info.. so yeah not much.
I really just don't think it's serious or anything. I really have no idea why the cardio seems to think so. I wish she would explain more. I am tired of dealing with it though and just taking the meds like the cardio said to do.. 2 times a day now so hope that helps and I can get on with my life/day :)
Thanks all!
I only have a 1 page summery of the report which does not says much. It does have this:
Longest SVE run =377 beats, Fastest SVE run = 152bpm.
That is all it days. Does not say what type of SVT, again just a 1 page report.. pretty much just like 1/3 of a page filled with information the rest my name and info.. so yeah not much.
I really just don't think it's serious or anything. I really have no idea why the cardio seems to think so. I wish she would explain more. I am tired of dealing with it though and just taking the meds like the cardio said to do.. 2 times a day now so hope that helps and I can get on with my life/day :)
Thanks all!
when I typed it, made perfect sense....ummm I'm going back to my corner now and have some coffee before I type again heheheh after I read it - made no sense AT all lol a piece of it was missing; I knew there was a reason the dr's can't find my brain; parts of it are missing lol...so sorry Candi
Hi!
Yes, the calculations above are correct.
900 SVT beats aren't the end of the world, but it all depends on how rapid the supraventricular tachycardias were. It also depends on which supraventricular tachycardia(s) you had, there are 10-12 of them. Further, it's not clear to me if the SVT's were 900 beats long each, or if 900 beats is the sum.
I don't know your age, but a supraventricular tachycardia at 200 BPM, as Jon refers to, is usually well tolerated in young people. A higher heart rate (250+) will often cause near-fainting or fainting, and if that's the case with you, it's something you should get treated. I see from your description that your doctor only wants you to use beta blockers. I didn't know antiarrhythmic meds caused serious side effects unless you are predisposed for a so-called long QT time, if you are (your cardiologist would know this by now), antiarrhythmic meds may have very serious side effects (possibly triggering ultra-rapid ventricular tachycardias with a French name).
I would as mentioned guess it depends on the symptoms (is your day ruined by this? do you faint? etc..) and which SVT you are suffering from. Ablation, where they burn the pathways that maintain the arrhythmia, is an alternative with some SVT's, especially the so-called AV nodal reentry tachycardia and the AV reentry tachycardia. Did your doctor mention any of those?
Yes, the calculations above are correct.
900 SVT beats aren't the end of the world, but it all depends on how rapid the supraventricular tachycardias were. It also depends on which supraventricular tachycardia(s) you had, there are 10-12 of them. Further, it's not clear to me if the SVT's were 900 beats long each, or if 900 beats is the sum.
I don't know your age, but a supraventricular tachycardia at 200 BPM, as Jon refers to, is usually well tolerated in young people. A higher heart rate (250+) will often cause near-fainting or fainting, and if that's the case with you, it's something you should get treated. I see from your description that your doctor only wants you to use beta blockers. I didn't know antiarrhythmic meds caused serious side effects unless you are predisposed for a so-called long QT time, if you are (your cardiologist would know this by now), antiarrhythmic meds may have very serious side effects (possibly triggering ultra-rapid ventricular tachycardias with a French name).
I would as mentioned guess it depends on the symptoms (is your day ruined by this? do you faint? etc..) and which SVT you are suffering from. Ablation, where they burn the pathways that maintain the arrhythmia, is an alternative with some SVT's, especially the so-called AV nodal reentry tachycardia and the AV reentry tachycardia. Did your doctor mention any of those?
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Actually, assuming a rate of 200 BPM which is what is listed as normal for SVT, that would be 4 1/2 minutes. This would really be normal SVT, but I'm sure it was very uncomfortable, but should be able to be controlled well with meds, I have heard that sotalol or flecainide work well on SVT.
Jon
Jon
Dividing the 900 total beats she had (I assume this was an estimated number) by the number of episodes only gives the number of beats per episode, not the speed at which they occurred. Say I ate 100 Oreos during 4 snack times one day. If I divide the total number of Oreos by the number of times I ate them, you'll know how many I ate each time but not how long it took me to eat them. LOL
In her case, she could have had 225 beats but they could have been at 120 beats per minute or 150 bpm or 197 bpm. We don't know. Am I making sense yet? It's getting late too. That never helps.
In her case, she could have had 225 beats but they could have been at 120 beats per minute or 150 bpm or 197 bpm. We don't know. Am I making sense yet? It's getting late too. That never helps.
that's why I said hopefully someone else will chime in...my mushy mind ...but if it was 900 beats and she had 4 episodes wouldn't you divide the 900 beats by the 4 episodes? I'm lucky to do simple addition these days...so I'm sure I'm wrong was just taking a guess at how to do it =) nahhh that doesn't make sense arrrggg sorry I'm sure someone will tell you...
no coffee no sleep my mushy mind = no good... that much I can add up lol
no coffee no sleep my mushy mind = no good... that much I can add up lol
I'm trying to understand your math. She had 4 SVT episodes. I'm not clear if each run was 900 beats long or if there was a total of 900 beats for all 4. Let's assume there was a total of 900 beats as you did. Divide that number by 4 and you get runs of about 225 beats for each run. That still doesn't tell us how fast those beats were occurring. What am I missing? Perhaps Candiflip will add some more information.
It could be tachycardia also; I know my hr runs of 3-5 minutes daily where my hr is 200+.
900 beats divided by 4 SVT episodes= 225bpm; which I've heard some like Cindy were 300 bpm - maybe ask in the HR forum also =) I think it's pretty common with SVT patients....unless I'm completely off mark here =)
hopefully someone will chime in who knows - my brain is mushy these days and I've been out of reading for a few weeks.
900 beats divided by 4 SVT episodes= 225bpm; which I've heard some like Cindy were 300 bpm - maybe ask in the HR forum also =) I think it's pretty common with SVT patients....unless I'm completely off mark here =)
hopefully someone will chime in who knows - my brain is mushy these days and I've been out of reading for a few weeks.
If it was v-tach, you would probably be unconscious. The fact that it was atrial tachy means it's very uncomfortable and annoying.
Did she say what your heart rate was? If it was 150 beats per minute, that means it ran about 6 minutes long. Again, not the longest on record. Some folks get SVT that lasts for hours and have to go to the hospital to have it converted back to normal sinus rhythm.
I'm not trying to minimize your SVT but I'm hoping to calm you a bit. Yes, you have arrhythmia problems but there are many with SVT who live long lives. I've had arrhythmias for as long as I can remember, SVT included, and I'm 58, have 3 grown children and have been working with wildlife for over 20 years now. Please don't get discouraged.
As for medications, there are quite a variety out there and I'm sure the doctor can find one that works for you without a lot of side effects. Some are stronger than others but get informed, ask questions and then work with your doctor.
Did she say what your heart rate was? If it was 150 beats per minute, that means it ran about 6 minutes long. Again, not the longest on record. Some folks get SVT that lasts for hours and have to go to the hospital to have it converted back to normal sinus rhythm.
I'm not trying to minimize your SVT but I'm hoping to calm you a bit. Yes, you have arrhythmia problems but there are many with SVT who live long lives. I've had arrhythmias for as long as I can remember, SVT included, and I'm 58, have 3 grown children and have been working with wildlife for over 20 years now. Please don't get discouraged.
As for medications, there are quite a variety out there and I'm sure the doctor can find one that works for you without a lot of side effects. Some are stronger than others but get informed, ask questions and then work with your doctor.
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