holter monitor results

I am a 39yo wf, nonsmoker and nondrinker.I have a holter monitor done each June. Typically it shows I have around 10,000 PVCs per day. I have sort of adapted to these as best as I can.They apparently have a new system for interpreting the results. This year I had a 48hr holter which showed 2000+ pvcs the first day and 549 the second day. These pvcs were isolated. On top of that I had 258 bigeminal episodes. Having known that I usually have around 10,000 per day ,how do I know if these current readings show improvement or not? I started having bigeminy regularly last October. My elctrophysiologist doesn't seem concerned nor does he feel I need to come for an appt. at this time. Is bigeminy considered better, worse or indifferent? If you could let me know the current thought on this I would appreciate it.(I do take toprol 25mg bid)

[Cleveland Clinic]

mom,

thanks for the post.

All of those findings are indifferent if youve have a normal cardiac evaluation of your arrythmias.  A lot of people notice changes over time.

good luck

[tickertock]

Even though PVCs are pain for many people that have them, with a normal cardiac evaluation, cardiologists and Electrophysiologists are strongly discouraging persons from paying too much attention to them as their benign prognosis is becoming more and more established.

Most of the potential "cures" are often associated with much greater risks than the PVCs themselves, if you respond well to beta blockers that is usually the strongest medication recommended and all other antiarrhythmics are avoided, though a few seem to benefit from a PVC ablation though, the long term success of this procedure is not as established as in other arrhythmias, at least this is what has been explained to me by most cardios and Eps that I have consulted, but as a fellow PVC sufferer I fully understand your concerns. Good luck.

[tickertock]

During an exercise stress test , I had probably about a total of 10-15 isolated PVCs during the whole test, these occurred before the test while being hooked up (at the rest stage) , during and after, mostly all felt different,some just like you desribe ,as if some were early, then late, but when viewed on the monitor they were the exact same PVCs, all unifocal coming from the right ventricle if I remember correctly. I thought it strange as well but it was clear to be seen on the monitor how the same PVCs can actually feel different, but from then I know they can.

The same arrythmia can feel different at times, I really don't know why, but from documentation of the actual arrhythmia while its occuring I know it can.Hope this helps, of course this might not be the same for you, only if you are monitored you'll be able to know for sure.

[Jeff-67]

Hi Tickertock,

I was wondering, for no particular reason, do you notice a wide variation in how early your ectopics are? I notice some of mine are barely early, while others feel like I have a 2 second pause after the ectopic.

[gigi54]

Hi Momto2.  I'm a 54 year old non-smoking woman who rarely drinks.  I have always taken great care of myself and am very healthy, but do have an anxiety disorder which I believe is the source of my cardiac ectopy (PVCs).  I recently wore a 24 hour Holter monitor and the results were as follows: 6,466 ventricular ectopics with 1,446 in trigeminy and 218 runs of bigeminy which totaled 842 beats.  I have had documented couplets (two together) in the past. My ejection fraction is 64% and I had a negative stress treadmill test which was only stopped because I reached 100% of my predicted HR.  I did have ectopy during recovery from exercise, but they consider it to be benign.  I have taken beta blockers, but they slowed my heart rate down to the low 40s and I had to stop exercising because my HR wouldn't go high enough to get the necessary oxygen to my brain and muscles.  I quit the meds and am back to running 4 to 5 miles, weight training, and kayaking.  The feeing of frequent ectopy is very scary at times, but I've learned to live with it.  Several very good cardiologists tell me that my condition is benign and I have little choice but to believe them.  I think that it's the adrenalin dumping from anxiety that triggers the PVCs and from what I read, many many other people have the same problem to one degree or another.  The number of PVCs changes drastically over time, based on what's going on in my life.  I sometimes take very small doses of Xanax when it gets so bad it feels like the ectopy is taking my breath away, but no drugs otherwise.  I guess that you've been told to stay away from caffeine and any other stimulants---they make it much worse in most of us. I've been living with this for over 20 years and my heart's still pumping along.  I think that the best thing is to try as much as possible to not worry about it unless you develop new symptoms that you should bring to the attention of your doctor.  And enjoy your life and kids!!!

[Skipping]

It sounds like this PVC thing is more common than I thought.  I'm a 39 year old white male that just started up with these a couple months ago.  I don't drink (even caffiene) or smoke but indulge in stress as I'm merging my company and starting a separate entity at the same time.  I love to be busy but it may be catching me.  The results of the 24 hour haltor showed over 19,000 unifocal PVC's.  The doctor said this is more than he's ever seen by far so it worried me.  But it sounds like many of you have had to live with this and company provides some comfort. I've got an appointment with a cardiologist this Wed (Aug 24) but I'm expecting a benign report.  You all sound very calm and strong given the odd sensation these things give off.  I guess 20 years of surviving the odd thumps will gain some confidence of normalcy.  I read that the life expectancy of those with PVC's (and a healthy heart) is no different than those with no PVC's.  That always nice for the dependant kids and wife!

[upbeat63]

Yes it helps to know you are not alone. I had a 48hr holter done recently because my PVCs seemed more than usual (22 year history) and it showed 24,000/day. That was double from before, but still the stress/echo came back "normal". Right after that I started almost constant bigeminy and NSVT. A little toperol for a few days stopped that, but the high frequency continues. I got very used to 12,000/day in fact for 5 years didn't really notice them, still had them, just wasn't noticing them. I guess I will get used to 24,000/day as well, or maybe they will go back down with hope and prayer.

Good luck with your cardio appointment, I hope all is "normal" for you as well. But it helps to read some of the many posts because despite all the medical reassurance, palpitations are still miserable. But life can be good if you let it be.