NSVT

[andie5]

I recently posted about 2 weeks ago...I was wearing an event loop recorder for 30 days and had a 6 beat run of VT adn docs put me on 25 mg of metoprolol once a day. I had a bad episode and ended up in the hospital...had cardiac cath and it came back good. Dr. put me on toprol xl 25 mg twice a day....had echo the next week and showed normal. I had an EP study done this Tuesday and doctor said it was negative, they couldn't induce VT or any dangerous arrhythmias--the palps were coming from the upper chambers of the heart and I had nothing to worry about and didn't need to continue on the Toprol if I didn't want to and scheduled me to come in for appointment in a month. She said it was likely the event recorder made a mistake and that sometimes the external monitors do make mistakes and I didn't have VT or NSVT because they couldn't induce it on the EP study. Is that possible for the monitor to pick up a "mistake" like that? If it cannot be induced in EP study do I really have nothing to worry about? She just said I may feel some palps, but they are nothing to worry about. I am just confused by all this. I wasn't told exactly what type of upper chamber arrhythmias they found...just told not to worry. Thanks for your help...I am just looking for a second opinion.

[Michael J. McWilliams, M.D.]

The software for Holter monitor interpretation of arrhythmias does make mistakes.  These mistakes can be picked up by reviewing the arrhythmias reported on the monitor.

If you have normal coronary arteries, a normal echo, a normal EKG, and a normal EP study, your risk of a life threatening arrhythmias is the same as anyone else walking on the street with a normal heart.  I agree that if the tests results are normal, you do not need to worry.

Short runs of atrial arrhythmias (atrial tachycardia) do not need further intervention.  If they sustain, medications and sometimes ablation is appropriate.

I hope this helps.

[andie5]

The "bad episode" was my BP was up and heart rate was up, so I went to hospital. The 2nd EKG they did was slightly abnormail--dr. said it show an atrial tachycardia. Everything else, CT scan, echo, was all normal.

[andie5]

The monitor I was wearing was a loop recording event monitor--not a Holter--I transmit the reading by telephone--is that similar to Holter in the sense of mistakes?

Thanks for your help!!

[Michael J. McWilliams, M.D.]

Event monitors are less likely to make a mistake.  I guess it depends on if the NSVT they saw was artifact (noise, not real) or just that they are now saying that it is not significant because all the tests are normal, you are low risk.

[andie5]

Would it be easy to tell if it was artifact? When I took the reading, I just felt like my heart skipped a beat and I was driving in my car. I tried to stay as still as possible, but did move some toward the end of the reading. When I do feel the palpitations, I don't necessarily feel like my heart rate increases, but I have never really took it to be sure. Would your heart rate definately go up during NSVT? It only feels like it lasts for a second or two (the palpitation). Thanks again.

[wmac]

Hi Andie5, I too have nsvt..I have woren a 24hr monitor, king of hearts which is what I think you were trying to say you had, I also had a loop recorder. A loop recorder is one they implant into your body and its for about 12-14 months. You have to go to a cardiologist to have it down loaded you cannot do it over the phone.
I have had 5, 7, 10, 3,and even a 26 beat run of nsvt. My heart rate went from normal to 187beats per min in a split second or less.
I also have svt, aivr, pacs, and pvcs.. I had two ep studies and they could not induce nsvt either time but they put me into vfib the first time because they were so aggressive with my heart. Yes they tell me not to worry either. lol
I have had lots of stress test, stress test with dye, tilt table test, echos lots of them, ekgs lots of them single average test mri of the heart I think everything possible known to man. My EF is 67% which is normal and that is why they dont worry.
Never once did they tell me they made a mistake and that I dont have nsvt because I kept asking that I was hoping for a mistake because I dont want it. But I do have it.
They also told me what Dr. Mcwilliams said with a normal heart and with it not being induceable we are at no greater risk than anyone who doesnt even have it.
It doesn take the fear away.   Good luck
wmac