Holter report, long wait for a follow up

Hi,

I have been experiencing heart palpitations for the last several months.  This lead me to an appointment with a cardiologist and subsequently a stress test and  24 hour holter monitoring (stress test results were normal).  Because of the upcoming holidays, I am not able to get schedule a followup with the cardio until Jan 20.  I feel certain that if there was anything alarming on the report, he would have made an appointment much sooner.  I stopped by the office today and picked up a copy of the report and was hoping that someone could give me some insight as to what all this means.  Due to space and time, I'm only going to list the things that show up as irregularities in the report.

Ventricular Ectopy:
Total VE Beats:    11 (0.0%)
Single/Inerp. Ve:s: 11

Superventricular Ectopy:

Total SVE Beats:      3699 (3.3%)
Atrial Runs:               3
     Beats:                  12
     Longest:               6 Beats @ 1:22 am
     Fastest:               154 bpm @ 8:58 pm
Atrial pairs:                4 Events
Longest: N-N              1.3 sec at 9:39 am
Single PAC's              3356
Bi/Trigeminy               112/211 Beats

I should mention that I am a 50 year old male, non smoker, 6'3" and 225 lbs.  I have have a sedentary job and have not been a regular exerciser and no history of heart trouble.
      

[itdood]

You are correct, bad news travels fast.    You would have been called back in that day if they saw anything that concerned them.

The bottom of you heart (the ventricles) have very minimal ectopic activity or what is called premature ventricular contractions (PVCs).  Be happy with it.

The top of your heart has more activity.  You are getting a lot of premature atrial contractions.  A great majority of these are isolated meaning they only happened one beat at a time or in patterns like bigeminy or trigeminy.  

There were 3 in which the PACs were firing in succession.  These should get a bit more attention.  There was one time where there was 6 PACs in a row.  These "runs" are a bit more concerning but given the number of PACs you have the runs aren't surprising.  

The Bi / Trigeminy PACs means there were 112 beats where PACs were occurring every other beat.  There were 211 beats that occurred every 3rd beat.  The atrial pairs means a "couplet" or where two PACs fired right in a row.

Positives are:  the trouble makers are happening in the atria, not the ventricles.  
Negative is:  The high load of PACs

Your next steps are probably going to be to get an echo to ensure the structure of your heart is OK.  this will check valves, dimensions, blood flow, ejection fractions.

I would also recommend a test to rule out any CAD issues.  The simplest is a nuclear stress test but it can sometimes have false negatives.  The next one would be a cardiac CT scan which is better than the nuke stress.   The next one would be a cardiac MRI which is excellent but expensive.  The next would be a catheterization.

If all that is good your options will be trying to eliminate symptoms that bother you.  You can either deal with it, try some life style changes, or try blood pressure meds like a beta blocker or calcium channel blocker (the latter of which I'm not a big fan of for treating benign ectopics).

Lets not jump ahead though, I'm just trying to give you an idea of next steps.  Don't draw any conclusions yet.