Ectopy Interpretation Fanatics...

[anacyde]

Does anyone know how the definitions for rare, occasional, frequent, etc. for ectopy?  I used to have a chart, but I can't find the thing anywhere.  Based on frequency/number of beats in a 24 hour period, they are typically classified based on percentage of total beats.  If someone could enlighten me as to those categories, I'd appreciate it very much.

[dolfnlvr]

Funny.  I can't help it, but isn't it always nice to know that you are "irregularly irregular?"  Kind of a double negative isn't it???  

Thanks for the info.  I was just curious when I saw it in your post.  I haven't seen that on my chart, or heard the doctor bring it up, but it was one of those things that made me want to gather more info.  Interesting.  

But mroe than anything, I find humor in the descriptors.  Especially the Irregularly irregular rhythm.  Suits my experiences pretty well :-)

[deedle1976]

I had to google it when I got home as the cardiologist wasn't concerned about it, he just wants to catch my suspected SVT.
Anyway multifocal atrial rhythm is also called 'wandering pacemaker.' It means that parts of the atria other than the sinus node are taking over the job of pacemaker.

"A wandering atrial pacemaker is an irregularly irregular rhythm with a ventricular rate less than 100 BPM, characterized by at least three different P-wave morphologies on the same strip, each associated with their own PR interval. Contrary to a tracing with frequent PACs, there’s no underlying regular rhythm associated with it."


"The presence of more than one pacemaker (the usual sinoatrial node) located within the atrium. It has been postulated that this rhythm may be an exaggerated form of respiratory sinus arrhythmia, such that other latent atrial pacemakers discharge when the sinoatrial node cycles to a slow rate during expiration."

You get P waves that look slightly different (due to coming from different areas) and the PR interval varies for the same reason. The P wave corresponds to the atria contracting and is the little bump on the ekg before the larger bump (which corresponds to the ventricles contracting).


Anyway the cardiologist says it might just be an artefact but it was nothing to worry about anyway. Apparently it can be caused by a high degree of variation in vagal tone in normal healthy people.

[dolfnlvr]

Explain multifocal atrial rhythm and how it is caught on the monitor please....

[deedle1976]

There is no fixed definition really, it depends on the person using the terms. The Lown classification that momto3 gave of >30/hour as frequent is a common one. The two cardiologists I have seen use >1% of beats as  frequent. I had 1786 PVCs and the report said 'frequent'. Another time I had 560 and it said 'Very occasional'. I saw my cardiologist this morning and noticed the next patient's report on his desk. I couldn't help having glimpse at it and saw that they had 1475 PVCs and several couplets. The summary said 'occasional ectopy'.

Today I got the results of my first holter since I started taking a beta blocker. The cardiologist thought perhaps I just wasn't feeling the PVCs as much but I was right.... zero PVCs and Zero PACs !!! I was thrilled about this I've never had less than 500 on holter before. I though 'how wonderful that my heart is beating so perfectly' until I read that I had 'multifocal atrial rhythm throughout'. oh well at least I can't feel it.

[Momto3]

This is the only one I've seen.  Hope it helps.

PVCs usually are described in terms of the Lown grading system for premature beats. The higher the grade, the more serious the ectopy.
Grade 0 = No premature beats
Grade 1 = Occasional ( 30/h)
Grade 3 = Multiform
Grade 4 = Repetitive (A = Couplets, B = Salvos of = or > 3)
Grade 5 = R-on-T pattern

This excerpt is from an article by Dr. Sarah Stahmer: http://www.emedicine.com/EMERG/topic773.htm#targetL

Connie