holter moniter questions

I RECENTLY HAVE BEEN HAVING ALOT OF  SKIPPED HEART BEATS & FINALLY WENT TO A CARDIOLOGIST.
I HAD A 24HR. HOLTER SHOWING 19 PAC'S, 300 PVC'S WITH 15 COUPLETS. I RUN 3 MILES ABOUT 5 TIMES A WEEK AND MY HEART RATE IS USUALLY IN THE 50'S. MY DOCTER RX METOPROLOL 1/2 25 MG. 2 X DAY.  IT  SEEMS THAT WHEN MY PULSE IS SLOW I HAVE MORE SKIPPING & WITH THIS BETA BLOCKER MY PULSE SOMETIMES DROPS TO 48. HE SAYS I'M SENSITIVE TO BETA BLOCKERS. MY NUCLEAR STRESS TEST SHOWS >70% RESTING EJECTION FRACTION AND ALL NORMAL.  2D ECHO/DOPPLER EF 55-60% TRIVIAL MR AND TRIVIAL AR. ALL NORMAL. DON'T KNOW WHAT THIS MEANS? HE TOLD ME THAT EVERYTHING IS NORMAL AND I HAVE A HEALTHY HEART. THIS SKIPPING GIVES ME ANXIETY. I THINK THE BETA BLOCKER SLOWS MY PULSE TOO SLOW AND MAKES THEM WORSE EVEN THOUGH ITS A SMALL DOSE. IS THIS REALLY NORMAL?

[is_something_wrong]

Hello,

What you describe is normal.

PVCs (not necessarily PACs) are more common with lower heart rates. The reason is your heart has longer resting cycles, and you are more vulnerable to get a PVC, the later the next beat occurs. My cardiologist told me that several "PVC sufferers" put on beta blockers get a paradox increase in their PVCs.

Your echo results are beautiful, your EF is well within normal limits for both test methods (it's common to have lower EF on echo than nuclear stress tests, as far as I know >50% is normal on echo, and >60% is normal on nuclear stress tests.). We all have small regurgitations on our valves, it's the way they work, some blood must necessarily run back for them to close.

You should ask your doctor (don't do anything without asking him first) if it's really necessary to use beta blockers. With your nice, low heart rate, its probably not necessary at all, but you should always ask him first.

Good luck!

[debbier]

I would ask the dr if you could just take 1/2 once a day of the toprol instead of taking it twice a day.  If your taking a beta blocker to relief your palps are they are worse due to the meds they your dr needs to try something else.   Are they worse on the toprol?  If so I would ask to go off of the meds all together.  I take atenolol and I am down to 1.2 dose due to palpitations.    I would definetly discuss your options with your doctor and get a treatment plan that helps!  Good Luck!

[jondsam]

As long as you are not having symptoms like light headeness etc. the beta blocker dose you are on should be fine.  I have been on beta blockets for awhile and my heart rate is usually in the mid 40's low 50's.  The doctor says that is perfect as my heart is not working as hard, and the beta blockers are actually great for the heart.  A 25mg dose of atenolol or something similar is extremely low.  A dose that low is more or less homeopathic.  Usually the smallest dose that you would see any benefit from is 50mg.  Especially with a beta blocker like atenolol with a half life of 5 - 6 hours a 25mg dose would practically clear out of your system before 24 hours.  The number of PVC's you are having is extremely low.  Sounds like you are in great shape and have little to nothing to worry about.  Im suprised the doc even wrote you are prescrip. for a normal holter results like yours.  Anyways take care

[is_something_wrong]

Hello,

What you describe is normal.

PVCs (not necessarily PACs) are more common with lower heart rates. The reason is your heart has longer resting cycles, and you are more vulnerable to get a PVC, the later the next beat occurs. My cardiologist told me that several "PVC sufferers" put on beta blockers get a paradox increase in their PVCs.

Your echo results are beautiful, your EF is well within normal limits for both test methods (it's common to have lower EF on echo than nuclear stress tests, as far as I know >50% is normal on echo, and >60% is normal on nuclear stress tests.). We all have small regurgitations on our valves, it's the way they work, some blood must necessarily run back for them to close.

You should ask your doctor (don't do anything without asking him first) if it's really necessary to use beta blockers. With your nice, low heart rate, its probably not necessary at all, but you should always ask him first.

Good luck!

[FLIPPINPATTY]

THANKS FOR YOUR SUPPORT!  I HAVE NOT BEEN AS SOCIAL LATELY BECAUSE I GET MORE PVC'S WHEN I AM ANXIOUS ABOUT ANYTHING. WONDER IF IT HAS TO DO WITH ADDRENAL RELEASE? ALSO, IF I TRY TO TAKE MY PULSE OR FOCUS ON MY HEART BEATING IT SEEMS TO GET SLOWER AND SLOWER AND I START GETTING PVC'S. I REALLY TRY TO NOT THINK ABOUT THEM. I HAVE HAD THEM FOR A LONG TIME, BUT RECENTLY MY BP TOP # HAS BEEN UP AND I WENT TO A CARDIO. I HAD THYROID CANCER 10 YRS. AGO AND THEY KEEP MY TSH AT .02 FOR SUPPRESSION, WHICH WOULD BE HYPER -THYROID LEVEL. MY SMALL TOWN GP WAS WANTING TO LOWER MY SYNTHROID MED...NO WAY I COULD DO THAT, SO I WENT TO THE CARDIO DR. HE PLACED ME ON DIOVAN FOR MY BP AND THE METORPROLOL 25MG FOR MY PVC'S. HE RAN ALL THE EXTRA TESTS TO CHECK ON MY RHYTHM...WHICH MADE ME FOCUS ON THEM.  I THINK ITS A
VICIOUS CYCLE. THE MORE YOU WORRY ABOUT THEM, THE MORE YOU HAVE...