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24 hour Holter results

Hi all! Just got my results back and wonder what you think? Thanks!!

Analyst's Impression:
Sinus rhythm predominated the 24-hour monitoring period, with overall rates from 44 to 121 bpm. Sinus bradycardia and sinus tachycardia were also noted.
The mean ventricular rate was 70 bpm.
Rare PACs were noted.
No PVCs were noted.
The longest R-R interval was 1377 ms., and was of a sinus mechanism.
There were no episodes of SVT, WCT, progressive or high-grade AV block or sinus arrest.
No entries were recorded in the Holter diary.
Due to the quality of the ECG data, ST evaluation could not be reliably completed.
Recording quality was fair overall. bc/ddg 05-18-15

Monitoring started at 2:03 PM and continued for 23 hr 59 min. The average heart rate was 70 BPM. The minimum heart rate was 44 BPM, occurring at 3:01:07 AM. The maximum heart rate was 121 BPM, occurring at 4:24:07 PM.
The patient's rhythm included 8 hr 11 min 35 sec of bradycardia. The slowest single episode of bradycardia occurred at 3:00:59 AM, lasting 1 min 54 sec, with minimum heart rate of 44 BPM.
The patient's rhythm included 38 min 55 sec of tachycardia. The fastest single episode of tachycardia occurred at 4:23:15 PM, lasting 1 min 54 sec, with maximum heart rate of 121 BPM.
Supraventricular ectopic activity consisted of 4 beats, of which, 1 was single PACs, 3 were in trigeminy. The longest R-R interval was 1.4 seconds occurring at 3:26:12 AM. The longest N-N interval was 1.4 seconds occurring at 3:26:12 AM.
QT interval averaged 407 ms during the monitored period. QTc interval averaged 434 ms during the monitored period. Maximum QT interval was 506 ms during the monitored period, occurring at 3:39:30 PM. Maximum QTc interval was 642 ms during the monitored period, occurring at 3:39:30 PM. Minimum QT interval was 302 ms during the monitored period, occurring at 4:24:00 PM. Minimum QTc interval was 380 ms during the monitored period, occurring at 11:24:00 PM. The percent of average QTc greater than 450 ms was 14%.
4 Responses
Avatar universal
Also, I am wondering if prolonged QT needs to be sustained for it to be considered an issue?

Here is the graph of my QT and QTc: https://www.dropbox.com/s/yi20jyqqu31k6tw/Screen%20Shot%202015-05-19%20at%2011.39.10%20AM.png?dl=0
1124887 tn?1313754891
The heart rhythm is perfect. 4 PACs is almost nothing, probably far less than average.

You should ask your doctor about the QT interval. Holter monitors are not reliable, the prolonged QT could be an error/artifact. I've never heard about QT changing that much in just a couple of hours.
Avatar universal
Agree with the above - follow up with your EP about the QTc interval.  The graph looks incredibly noisy  and as mentioned above, the prolonged QTc could very well be an error/artifact.  Everything else looks great.
Avatar universal
Did a couple of follow up resting and standing EKGs today. Came back with QTcs of 501, 507 and 512 just off the bat without looking at the others. Going to an EP soon to see about Long QT treatment.
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