Holter results

Hello  I am a 42 year old female.  I have been feeling palpitaions and runs of strange heart beats for some time now.My holter monitor results this week were as follows:
Ventricular ectopic activity 2578 beats.  2521 were in single PVC's 4 were interpolated; 3 were in R on T 35 were in bigeminy 5 were in trigeminy and 10 were single VE's

Supraventricular ectopic activity consisted of 31 beats .  !2 atrial couplets, 3 were late beats, 16 single PAC's

The longest r-R interal wa 1.5 seconds  The longest  N-N interval was 1.4

My GP  did not explain any of this and said not to worry!

Could anyone shed further light on these results and would a cardiology referal be in order.

My holter was actually on a " good day" when I have none of the runs of funny beats I feel from time to time.

Thankyou in advance

[Artaud]

Hi,

Definition of Ectopic: "In the wrong place. Out of place"  In the case of heart rhythm, an Ectopic Beat is one that occurred when it was not expected.

The Heart has two Atrial Chambers and two Ventricular Chambers. The Atria are on top of the heart, the ventricles on the bottom. If an ectopic beat occurs above the ventricles, it is referred to as Supra (meaning above) Ventricular. Supraventricular Arrhythmias are often not of as much concern as Ventricular Arrhythmias.

You had 2578 Beats that occurred when not expected. 2521 PVCs (Premature Ventricular Contractions) that occurred spaced from other PVCs, in other words, they were not a "Run of PVCs". Interpolated means to use existing information to gather data about something you did not directly measure. I am not sure of the exact context, but I do not believe that it refers to anything serious. Premature Ventricular Contractions are quite common, I have had them since I was 15, and I am now 50. For me, they come and go. I get episodes with more than 600 per day, with my last episode lasting longer than a year. Some people have thousands per day. BUT, anytime people begin to experience PVCs, they need to be examined by their Doctor to rule-out anything more serious.

3 were R on T, this is something you should ask your Doctor about.

35 Beats were in Bigeminy, in other words, they occurred in a pattern. The pattern is as follows: Normal beat, PVC, Normal Beat, PVC, Normal Beat, PVC, and so on. This pattern is not uncommon. Some people go into this pattern for hours. I had Trigeminy, for an hour or more at a time, which is Normal Beat, Normal Beat, PVC, Normal Beat, Normal Beat, PVC and so on.  So you had Bigeminy and Trigeminy for very short periods of time, usually quite normal. 10 were Single VE's. Although I could not find specifics on VE's, I do believe they mean Ventricular Ectopics, so I couldn't find how they consider these different than PVCs.

Supraventricular Ectopics occur above the Ventricles and often not considered to be as serious as some forms of Ventricular Arrhythmias. You had 2 couplets, meaning that you had two Atrial Beats in rapid succession, 3 of the beats occurred later than expected, and you had 16 Single Premature Atrial Contractions (PACs).

Heart rhythm is recorded on the EKG, whether on paper or on the monitor screen, in a pattern that is familiar to most people. Various aspects of this pattern are given names. The basic pattern is known as the QRS Complex. Google the following, without the brackets: [ EKG Wiki ] Once on the site, look for "Schematic representation of normal ECG" about halfway down the page. This shows the P, QRS, and T Waves. The R-R Interval is the distance from the R (as in QRS above) of one heart beat to the R of the next, basically it would reveal the Heart Rate, but in the case of the maximum R-R Interval, they are looking for the longest time, at some point during the test, that occurred between one heart beat and the next. If you would have 1.5 Seconds between every beat, your Heart Rate would be 40 Beats Per Minute. Hopefully, someone can edify me about the NN Interval, as I have fruitlessly searched the internet for a 1/2 hour and cannot get a straight answer. (Help me Celeste77 or any of you other erudites on this forum ;-)

To put the overall number of Ectopics in perspective, your heart probably beat nearly or more than 100,000 times on the day of the test.

Overall, it is good that your Doctor said that you have nothing to worry about, and many people on this forum have many thousands of ectopics every day. Yet, if I were you, I would consult a Cardiologist, perhaps he/she can order a 30 Day Event Monitor. This device, worn for 30 days (but can be taken off to shower), has a button you push whenever you feel symptoms. You then take the device to a phone, and transfer the information (it’s easy) from your device to the Technical Center. They can tell you right away what you had, and if it was serious, advise you as to what to do. The information would also be sent to your Doctor. Ask the Cardiologist, if you elect to see one, about the R on T  PVCs. Concerning this phenomena, a Doctor on this forum, in part, had this to say: “This is rarely a concern with PVCs and not something I would worry about. It is rarely picked up by an EKG or Holter”.

Nevertheless, a thorough consultation with a Cardiologist couldn’t hurt.

Be well, get sleep, and relax. Avoid Caffeine.

Hope this helps.

[mookles]

Artaud

I cannot thankyou enough for your most informative response. It has helped me understand the results and reassured me too.  It was so very kind of you to research the terms.I did post the Dr. too which reassured me as well, but he did not explain the results meanings like you have.

I have booked a cardiology consult but it is not until June! I live in rural Australia and consults have a lengthy wait due to shortage of specialists in rural areas.

I will further search as you suggested the terms given. reading the numerous posts onthis forum is helping my understanding and giving me peace of mind.

Reading  you have had this problem some 35 years and remain alive and well is reassuring too. I was scared witless last night and hubby was too.  Thinking we should fly straight to Sydney for an emergency consult !  I am happy to wait now until June, unless further problems arise before then.

Again THANKYOU.

[Artaud]

Hi,

Thanks for the thanks.

It's encouraging to see that other people have similar problems. Also, it's incredible what others have been through. My 600 + PVCs a day are miniscule in number compared to others 10,000 per day.

An amusing anectdote, when I was having Trigeminy, my wife and I and others were invited to her employer's house to watch a football game. I was nervous, and the more nervous I get, the more problems with Trigenimy that I would have. Her employer, a Cardiologist, is also my Doctor. He had done extensive testing and told me there was nothing to worry about. (Also, he had earlier seen an EKG that my wife took, after hours at the office, during one of my worrisome rhythms. When she gave it to him, he was reading something else. He took the EKG, said "oh, he has some Trigeminy, put the EKG results down, and went back to reading, he was not concerned). Anyway, that night, at his house, my heart was locked in the Trigeminy mode. I had to resist the urge to grab his hand and compel him to take my pulse to see how persistent the Trigeminy was. My wife, the next day, told him that I was in Trigeminy virtually the entire time I was at his house. He said, "oh, he hides it well".

Take care of yourself, follow up with your Doctor as planned and if anything seems really unusual, but most importantly, try to relax. Get more sleep and avoid Caffeine. (Two big factors in PVCs. Anytime I did not get enough sleep, I knew I was in for a difficult time, PVC wise, the next day).

Be well.