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Another 30 day event monitor question
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Another 30 day event monitor question

I'm day 27 into a 30 day event monitoring test - I have to say my stress level has increased throughout this test due to my "research" .

Anyway, I'm pretty sure I feel PACS and/or PVCs (and had no idea until recently that most people don't even feel these!).  I've seen several posters on this board mention they sometimes have thousands of these a day.  I'm wondering if anyone knows how accurate a 30 day event monitor would be a detecting the correct number of times this happens in a 24 h period?  For example, with the monitors that only hold a few recordings, a person who has 1000's of pacs/pvcs a day would be calling the information in hundreds or thousands of times a day if these were all recorded.  My assumption is the event monitor only detects a certain (small?) percentage of actual events and we dont feel all of the events either so dont record them all.  Anyone know if that is the case and what that number is?
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1807132_tn?1318747197
A 24 or 48 hour holter is a better tool for monitoring ectopics.  The event monitor is more for isolated events like svt or runs of ectopics.  The point of the event monitor is to catch a more elusive issue as opposed to a persistent issue.  If you are interested in pinpointing how many ectopics you have a day, which can fluctuate, then ask for a holter.  What did you get the 30 day for?
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Avatar_f_tn
I suppose that is also something I had been wondering.  If the event  monitor is designed to catch more elusive arrythimas, does it even detect pvcs/pacs on its own (especially since so many people have thousands a day).

I'm on the monitor because occassionally i go through stages (weeks at a time sometimes) where I feel very uncomfortable palpitations (beyond what I would call normal, daily palps I feel).  I mentioned this to my previous dr about 7 years ago who said something along the lines of "yes, your heart is doing this right now.  This is a relatively common condition but if it goes on for more than an hour it might turn into something more serious which could lead to stroke so you should head to the er incase you need to converted    back to normal rhythm"...... Made an appointment with a new PCP a few weeks ago who said the others Drs comments were inappropriate and she has me on the monitor.  

The rhythm I was concerned about hasn't happened during this time but other things have been autodetected by the monitor.  This whole thing id causing me anxiety because I have no idea what is being captured and don't see my dr for another 2 weeks.  I need to quit googling.....
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Avatar_f_tn
And the reps don't help either.   I Understand they can't tell us what  is going on but I have had comments like "so all of this happened when you were sleeping?" which i feel is very inappropriate.  Im going to complain on the evaluation card that goes back with the monitor.  Sorry, just needed to vent.
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1807132_tn?1318747197
It sounds like your doctor suspected afib but unless an ekg was given at that time it is likely too difficult for that doctor to know why your heart was beating fast at that time so yes, probably inappropriate comments.  The event monitor I had did not self activate.  I was the only one to activate and then had to transmit the info over the phone.  The reps would check what I transmitted and if it was troublesome they would have me record another event to make sure I was OK before they hung up.   This happened when I had my svt episode.  By the time I sent the recording it had stopped but they had to make sure my heart rate was normal before they would let me go.  That said, I did have some flutters during the period I wore the monitor but didn't record them because I was solely focused on the svt episodes only.  I would think though if yours self recorded that your pvcs would be transmitted if your monitor indeed did something like that.  If that is the case they should know how many ectopics you have been having and what type they are pacs or pvcs.  But again, I am not familiar with your monitor so I don't know that for sure.  Well, I would think however your events are being transmitted to them and they aren't showing concern over the events then what is being caught is likely of no real concern.  They would not let you be otherwise.  I believe they are obligated to get you medical attention if your life is in danger.   That said, it is a bit disappointing that the reason you got the monitor for in the first place hasn't manifested for you during this month.  I would say your next steps would be to try and journal the symptoms yourself.  Get yourself a heart rate watch so you can get a reading on what your heart rate is when you have the episode.  Note how it started, what may have triggered it, how long it lasted, and how it made you feel.  Sometimes svts can be elusive but they do eventually get caught.  I do hope you can get to the bottom of yours sooner rather than later.
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Avatar_f_tn
Thanks for your help Michelle!

Yes, based on what my original dr said the only thing I can find that fits her description is Afib but no, she didn't do an ekg and made her comments to me based on feeling my pulse.  

I'm glad my new dr is following up with a test but  i wasn't expecting one so it caught me off guard.  My feeling is though, that I now have a good dr, so if it isn't caught this time and happens in the future I can possibly get a monitor at that time (it usually happens on and off for days or weeks at a time when it does occur).

I agree that nothing life threatening has happened otherwise the reps would have acted appropriately.  That said,  there have been several occasions when something transient was caught that concerned the reps enough that I had to make a live recording.  Ugh, just wish I knew what the events were and if it is something that might require follow up tests or treatment.   I've seen others say this and I agree, these tests in themselves probably result in more arrythimas due to the stress they invoke ( in some people, anyway).


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1807132_tn?1318747197
Afib isn't the only fast heart beat around.  There are all sorts of svts that are less dangerous than afib so I would not jump to an afib conclusion until all the facts are in.   Well if they called you then at least something was caught.  You can ask your doctor what it was when you get your results. I know the waiting can be tough but hang in there.  I am glad to hear you have a responsive doctor.  They are a godsend.  Take care.
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Avatar_f_tn
Well the only reason I was even thinking Afib was because the previous dr mentioned if it went on for too long it could lead to high risk of stroke - not sure of other conditions that do that but Im sure there are some.  The dr. never should have told me that, especially based on feeling my pause and not giving me any follow-up tests.

Also, the kind of monitor I have is one that I have to call the results in.  It can only hold 6 "events" and beeps when it has info in it, and beeps every MINUTE (lol) when it is full.  Thats why I was wondering about it detecting PACS/PVCS on its own.  If it did that, I cant imagine how this monitor would work with people that have thousands of these a day (they would need to call the results in every few minutes!).  I wonder if it doesnt even detect these events on their own since they can be so common and thats when people would push the button and detect those events themselves.  I suppose all monitors are different and there isnt really a good way to know which is programmed to detect what.
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1807132_tn?1318747197
It sounds like it isn't programed to detect the ectopics especially if you know you have had a lot and it hasn't gone off a lot.  It is likely looking for the fast beat or maybe a bunch of ectopics close together.  I am sure you will find out what it has captured once you talk to your doctor.  Keep us posted.  I am interested to hear.
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1423357_tn?1373023915
I'm inclined to say that event monitors aren't designed to auto-record one beat or two beat cardiac anomalies, but sustained changes in heart rate. I had loads of PVC's during my monitoring period but the recorder never triggered.  Many of the recordings I manually triggered myself by pressing the record button.  The monitoring lab was unimpressed with the PVC cluster recordings, but really snapped to when I phoned in my SVT.
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1423357_tn?1373023915
It may be useful to add here that when you press the record button, it jumps back a preset amount of time... say 30 seconds, then records real time for another preset time, often 3 minutes.

So, if you feel a "good" event, you have about 30 seconds after you feel it to press the button before it "scrolls" off the recorder and is lost. If you press the button within that 30 second period, it will jump back and commit it to memory storage along with several minutes into the future.
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Avatar_f_tn
At Tom, yes this is what I am starting to think too - it only auto-detects sustained or very out-of-the ordinary events.

There have only been 5 times that I have had to do a "live" recording.  3 of those times I was feeling palps and my HR was close to 50 and a little erratic.  The other 2 times were when the thing filled up after some pretty strenuous exercise.   Im guessing my HR was too high and they didnt like that.  The thing also fills up when Im sleeping.  When I phone it in it sounds like my HR increases during those events so it will be interesting to see if something is going on.   Of course, this is all in addition  to the elusive event I am wearing this thing for in the first place ;-)
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995271_tn?1408549100
I've seen the reports from CardioNet event monitors.  They're pretty darn accurate.  They track all events and send daily summary reports and strips of events.

On those, when you press the "event" button, all that does is place a mark along the strip to say "I felt something".    Pressing the event button doesn't place it into a recording mode.  It's always recording and uploading the data via the cell network.

It all depends on which one you use too, there's no standard approach.

The CardioNet monitors I'm aware of record at a pretty high resolution, they use 3 leads.    The resolution is as high as some of the "loop" recorders I'm aware of (the ones that record for 24 hours then you have to hand them back in).  The main difference is that the CardioNet event monitors can "phone home" so to speak and upload their data every so often so that their memory doesn't fill up.  Again, the event button does not trigger recording.  It's always recording.  The event button just puts a tick mark on the strip to note to the reviewer that you felt something at that time.

The cardionet montiors will also flag possibly harmful events and phone home right away.  Someitmes people aren't aware something bad happened.  The cardionet folks will call you when this happens to make sure you are OK and will also contact your doctor.

These are the only ones I'm aware of though, it might be different for other brands.
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2214462_tn?1339431583
This is older, but Cardionet does make multiple kinds of event monitor.

https://www.cardionet.com/medical_06.htm

Mine had two leads, "holds 6 recordings 60 [seconds] Pre/30 Post", and had to be called in manually with a service rep. I didn't have a landline and it wouldn't accept my cellphone or Google Voice. Stupid insurance..
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Avatar_f_tn
Following a SAH stroke a little over a year ago, I've been extremely tired, light headed and dizzy. I have also had heart palpitations and fluttering. Doc ordered a Lifewatch 30-day monitor. The first weekend I had it, I became very sick and thought I had food poisoning or a bug. The monitor folks called me to ask me questions. The following Monday, my doc's triage nurse called to tell me I had had a ventricular standstill event and a second degree heart block. She wanted me to know that I might need to be prepared for a pacemaker. She called back a little later to say that the doc thought it could have been caused by vagal something or other. Anyway, I've not had any more contact with the lifewatch staff or my doctor's office. Can I assume this means I'm not having any more issues?
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