holter monitor

[dhflp]

1.Are multifocal ventricular ectopics in singles(with 0 Ventricular Beats in Runs; 0 Venticular Runs; 0 Ventricular Couplets; 0 Ventricular Bigeminal Cycles) with Sinus rhythm exactly the same as benign PVC's when written on a 48 hour holter monitor report?If no what's the difference between them? 2.What's the number(range) of ventricular ectopics on 48 hour holter monitor,at CCF for an adult male,for classification "Very rare multifocal ventricular ectopics in singles" and "Rare multifocal ventricular ectopics in singles" to apply? Are the ranges 0-100 and 100-500 for the above very rare and rare classifications?If no what are the ranges? 3.At what minimal enlarged size do thyroid lobes have to be to cause ventricular and supraventricular ectopics? 4. At what range(s) does TSH blood test result have to be to cause ventricular and supraventricular ectopics in an average middle age adult male? 5.What's acceptable minimum heart rate as well as QRS complexes number on 48 hour holter monitor?6. Usually how many multifocal ventricular ectopics in singles or supraventricular ectopics in singles does person have to have on 48 hour holter monitor before it is treated with drugs?Thank you.

[cc1959]

A related discussion, benign heart was started.

[boriero]

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[boriero]

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[star1000]

I received the flu shot in mid Oct.  Three weeks later, I started to get this lurch feeling in my upper abs area.  When they happen, I noticed that my heart misses a beat.  Is there a coincident?  I never had this before and I have been getting the flu shot regularly for the last 5 years.

[sfjw]

Follow up question about thyroid and Hashimoto's thyroiditis and PVCs. I have been on levothyroxine for several years after treatment for Graves disease. Prior to that I had an occasional palpitation; more recently, two episodes where PVC activity went way up, having several per hour.

When this happened in October/November a year ago, I stopped taking levothyroxine and the palps went away completely in a week. Tests taken at that time showed "normal" TSH but no other thyroid test was done.

This year I switched endocrinologists. New one did a complete workup and I tested positive for Hashimoto's antibodies. I also had pulse rate at time of office visits of 45, 43, and 48 - low for me (49 YO male, average weight and condition). All other thyroid levels, T4, T3, TSH, continue to be normal. Well, T3 was in the low end of normal...

One week after my flu shot in October the PVCs came back, several per hour, and have persisted now for six weeks. My pulse is still in the 40s.

Is there a connection to Hashimoto's and bradycardia?
Is there any connection at all to the fact that both of these PVC episodes occurred right after flu shots?
Will raising the normal heart rate decrease PVCs and if so how can I do that? T3 therapy?

thanks

[dhflp]

At what minimal size is thyroid considered enlarged in adults,at what size are upper normal limits? Is antithyroidglobulin antibody test more important than other thyroid antibody test in diagnosis?

[Fran71]

Hi,
I suffer from sinus tachy and PVCs. Blood tests revealed that I have Hashimoto's thyroiditis. My thyroid function is still perfect - my TSH is right in the middle of the range - but I do have thyroid antibodies which indicate I have this autoimmune disease, which is likely to end up in hypothyroidism. The endocrinologist says this can't cause arrhythmia since my thyroid still works OK; my cardio says that I do have a thyroid disorder even now, so that might be related. My thyroid is not enlarged yet, though it's in the upper limit.
If you have an enlarged thyroid but your TSH is normal, I would ask your doc to check for antithyroid antibodies. Most doctors believe they alone can't cause arrhythmia, but some do, so that may be a reason for your symptoms.

Good luck

Fran

[Cleveland Clinic]

dh,

thanks for the post.

1.Are multifocal ventricular ectopics in singles with Sinus rhythm exactly the same as benign PVC's when written on a 48 hour holter monitor report?

Each company or interpreter of a holter may use different terminology. I would interpret this to mean PVCs.

2.What's the number(range) of ventricular ectopics on 48 hour holter monitor,at CCF for an adult male,for classification "Very rare multifocal ventricular ectopics in singles" and "Rare multifocal ventricular ectopics in singles" to apply? Are the ranges 0-100 and 100-500 for the above very rare and rare classifications?If no what are the ranges?

I dont know have the classification system or the terminology we use at the clinic available. The bottom line is what are the underlying rhythms.  ie...are there PCVs, PACs, NSVT, afib, etc...

3.At what minimal enlarged size do thyroid lobes have to be to cause ventricular and supraventricular ectopics?

The size of the lobes of the thyroid have nothing to do the the genesis of the ectopics. I think your reaching for details on this and overreading test. If the thyroid is going to have impact on the cardiac cycle it would be through its endocrine activity which is measured by the blood test...ie--TSH.

4. At what range(s) does TSH blood test result have to be to cause ventricular and supraventricular ectopics in an average middle age adult male?

It would have to be wither high or low which would be indicative of an underlying thryoid abnormality.

5.What's acceptable minimum heart rate as well as QRS complexes number on 48 hour holter monitor?

It is person dependant. Unless there are symptoms associated with a slow heart rate, there really isnt a specific number cutoff.

6. Usually how many multifocal ventricular ectopics in singles or supraventricular ectopics in singles does person have to have on 48 hour holter monitor before it is treated with drugs?

There isnt a number. PVCs are basically treated for symptoms  in someone with no other cardiac pathology. There are many people on this forum who have a lot of PVCs who never take medicines because the PVCs do not bother them. There are others who have undergone PVC ablation because the symptoms are so severe.

Again, its not the number of PVCs. Its the presence of symptoms or abnormal cardiac pathology that drives treatment.

good luck