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ectopic heartbeats

      Re: Re: Re: ectopic heartbeats

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Posted by CCF CARDIO MD - DLB on October 18, 1998 at 12:48:27:

In Reply to: Re: Re: ectopic heartbeats posted by Lynn on October 15, 1998 at 12:36:38:

: :
  : Dear Keely:
  : The QT interval is a measurement made from an ECG. PVCs can not cause Torsades, unless the QT interval is prolonged. Your cardiologist would have checked your QT interval. Mitral regurgitation will not affect the QT interval. The only way to be sure what your arrhythmia is or is not would be to wear a Holter monitor for long enough to capture the abnormal rhythm while you are having your symptoms.
  One of the truly wonderful doctors who answers so many questions here wrote the above
  to Keely.
  but, once again, here is the problem I think I  may share with others -- I've had
  a ridiculous number of holters and even a month long monitor. While it did capture
  pvcs , even a couple of "runs", and pacs.... while wearing a monitor my scariest
  "runs" of multiple erratic beats never, never occurred.  I can't wear a monitor for MONTHS
  at a time.... i don't have the money, my insurance company sure won't pay for any
  more, and my doctor certainly doesn't think it is necessary. Yet, bottom line, are you
  saying that WITHOUT having a specific  kind of beating caught on a monitor, then
  you can't really say what's going on with the heart rhythm? I thought all the other data
  could point to the fact that the heart seemed to not have sustained bad arrhythmias,
  etc.  I guess we all want reassurance and it sounds like  we have to have faith that
  what we feel, experience and ISN'T caught , since we can't wear a monitor all the time
  until it is necessarily caught, and some of us don't have these BAD feeling arrhythmias but only
  a few times a year...... we could be in danger but won't know until something bad happens? YIKES!
Dear Lynn:
I understand your question and concerns. I think wearing a Holter monitor for more than a few days is rarely necessary. If a patient is having serious arrhythmias, it should be captured in this period of time. I have never used a Holter monitor for a month. I was merely cautioning against the practice of wearing a Holter for 24 hours, perhaps missing the patient's symptoms, and erroneously concluding that the symptoms do not represent a serious arrhythmia or that the symptoms are due to non-cardiac factors. In someone without structural heart disease, if the EKG is normal and if the Holter monitor is unrevealing, then serious arrhythmia is very unlikely. While every patient wants reassurance, no doctor can say with absolute certainty that nothing bad will happen in the future.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

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