Can anyone translate what 24 hr monitor results mean?

[adviceseeker777]

Hi,
Just got the complete report from my cardiologist for my 24 hour monitor and of course it all looks scary and doesn't make much sense to me.  He didn't spend any time explaining it to me so I'm hoping someone may have more knowledge of what all this means.  Here goes:

total QRS complexes: 107397
Ventricular ectopics:  2
Supraventricular Ectopics: 36    (is this bad???)

under Ventricular Events:
Isolated: 2
In Bigeminal Cycles:  0
Couplets:  0
Runs: 0

under Supravetricular Events:
Isolateds: 3
Couplets:  15 (THIS WAS CROSSED OUT BY SOMEONE AND MARKED 'ARTIFACT')
Runs: 1  (CROSSED OUT)
Longest:  3 beats, 86bpm at 4:25pm (CROSSED OUT AS WELL AND MARKED 'ARTIFACT'...what does that mean?)

the interpretation reads:
The rhythm was normal sinus with rare ventricular and supraventricular premature contractions.  2 periods of sinus tachycardia were present with rates briefly up to 150bpm.  No clinically significant arrhythmias were recorded on this study.
Average heart rate was 75bpm. Heart rates greater than 120bpm were noted 3% of time. Less than 50bpm were noted less than 1% of time.
No pauses exceeding 2.0 seconds.
2 ventricular ectopics which represented <1% of total beat count were noted. The highest ventricular ectopic frequencey occured from 1 to 2 pm. During this time 1 VE occurred. Ventricular ectopics were observed as 2 isolated beats only. No couplets or runs were noted.

36 supraventricular ectopics which represented <1% of total beat count were noted. Highest Supraven ectopic frequencey occurred from 11pm-12am. During this time 24 SVEs occurred.  (WHAT DOES THIS MEAN? IS IT DANGEROUS?)

No episodes of ST depression were noted in channel 1, 2, or 3.

Can anyone explain this to me?  I'm 39 and having racing heart which is really scary and he's telling me it's in my head and not from my heart...
thanks to all,
k

[upbeat633]

Please don't worry about a slower heart rate, 50's and 60bpm are just fine.

So is your racing heart, although I'm sure you don't feel like it is, but in sinus rhythm at 150 that's really not too bad, since you've had a lot of other testing to indicate your heart is healthy.  

Continue to work on your anxiety issue. I know when I was in the worst of mine I didn't think there was ever going to be a way out, a better life. There was, there is, and I'm sure it will be the same for you once you feel like you are back in control instead of letting these health worries get the better of you.

I found a good book last year called "Full Catastrophe Living", it might be helpful for you?

[adviceseeker777]

thank you so much for explaining all of this to me. I have very bad panic attacks and severe anxiety and my heart races out of control.  It's hard to tell what is happening first though, so my psychiatrist wanted me to have my heart completely checked out to be safe.  I have been on all kinds of anti-depressants and anti-anxiety drugs to try to deal with this, but many times it does not help racing heart.  I have been to ER a number of times this year, have had about 4 different EKGs done, a sonogram on my heart and a stress test as well as this monitor.  The cardiologist says all is fine, it's all coming from my brain.
My shrink just changed my meds again...I'm now on Klonopin .5 2x a day and back on Prozac which was a lifesaver for me 17 years ago.  I stopped taking xanax because I was having to rely on it daily since the attacks and 'heart episodes' have been occurring chronically.
It just doesn't end.  Since yesterday, my heart rate resting has now gone down to anywhere in the 50s to the low 60s and I'm freaking out about that as well.  I keep thinking they are missing something in my tests and I am quite obviously a hypochondriac who cannot seem to focus on anything else but what may be killing me.  It's so miserable living like this.  I'm just hoping the new drugs will help get it under control and I will stop worrying about my heart.  In the meantime, I'm going to make sure my new 'slow pulse' isn't any more dangerous than the fast one....!
thank you so very much for your advice and translations.  Wish you all the best and much health!!!!
k

[madjlp]

That's a pretty darn positive holter monitor report.  Did you have any heart racing episodes while you wore the event monitor?  If so, then the events are benign.  However, if you did not have any of the events, you might consider requesting an event monitor which is similar to a holter but worn for a longer period of time (3 weeks is typical + or -).  I agree an echo sounds appropriate as it would largely rule out underlying structural issues.  The 24 SVE in an hour would not be considered a real problem though it may have been a cause of discomfort for you.  It also sounds as though that 24 SVE count may not be accurate if indeed it is the result of "artifacts" or, in other words, noise in the recording (for instance, if you went to sleep btw 11pm and midnight you could have jostled the electrode wires shifting in bed and produced some static in the recording).  To explicitly answer your question - there is nothing dangerous in your holter report and while pvcs and pacs are uncomfortable for some people, they are considered benign in the setting of a structurally sound heart.  Good luck

[upbeat633]

Did you keep a diary when you wore the monitor? Sometimes it's helpful to know what you were doing, or how you were feeling when some of these events were captured.

I think you are most concerned with knowing what supraventriclar ectopy is. I'm sorry your doctor did not explain it to you. Basically it is an extra beat coming from above the ventricle (there are four chambers of your heart: two atria ((on top)) and two ventricles ((on bottom)).

So you had 36 extra beats above the ventricles, therefore in the atria, which could also be called pre-atrial contraction or PAC. *Please someone correct me if I'm wrong--because I haven't had any PACs, only thousands of pvcs. Yours occurred mostly around midnight.

You also had 2 isolated (not together) ventricular extra beats, or pvcs.

You had tachycardia (heart rate above 100 bpm), but it was in sinus rhythm and the report says it was for a brief time. Sinus rhythm is normal, it is not ventricular tachycardia.

Out of the blue a racing heart can be uncomfortable, but if you were exerting yourself, or if you were in a stressful situation you could easily have a heart rate above 100bpm (120bpm to 150bpm is not uncommon for someone in a stressful event, business meeting, watching a scary movie etc.).

Despite not having it explained to you, the report really should give you a measure of comfort. It does state there are no serious arryhthmia issues, and your racing heart was in sinus rhythm. I understand that you might want an answer for the racing heart issue, but I've had free floating anxiety (brought on by nothing), and often my heart would instantly take off to 120bpm and above, along with pvcs at 20 to 30% of all of my heart beats. I really have to work on the anxiety issue, and that might be where you start too? If you haven't had an echocardiogram, that might help to put your mind at ease. Holter monitors are good to capture the electrical events, of which you had just a few, but an echo would give a picture of the structure of your heart. If that was good, then even if you jumped up to the thousands and thousands of pvcs that I get, you'd still be told the same thing, it's all benign.