24 hour holter report summary

[Stephanie71083]

I am a 26 yr female and did a 24 hr holter report. There were 120281 QRS complexes detected. Of these, there were 288 ventricular ectopic beats and 19, 243 supraventricular ectopic beats. There were 0 paced beats detected. The avg heart rate was 84 bpm. The heart rate ranged from 52 bpm to 130 bpm. There were 2 pause events, the longest 3.6 seconds. There were 237 isolated ventricular event4 in Bigeminal cycles, 20 couplets, and 2 total runs (longest: 8 beats, 55 bpm. Slowest: 8 beats, 55 bpm. Fastest 3 beats, 115 bpm) There were 3, 767 isolated supraventricular events1758 couplets, 3, 428 total runs (longest: 8 beats, 94 bpm. Slowest: 3 beats, 88 bpm. Fastest: 3 beats, 112 bpm.

What does this mean? How bad is it? Should I be worried?

[jeannie666]

I had the halter done, I  don't understand it at all
qrs complexes 119404
ventricular ectopies 132
supraventricular ectopics 642
isoloteds, ventricular events 94
0 bigeminal cycles
couplets 16
runs 2
longest beats 135
fasteest 3 beats 135
slowest 3 beats 114

supraventricular events 640
1 couplet
0 runs

st depression
ch1 15 episodes max 3.2mm
ch2 14 episodes max 3.2 mm
ch3 1 episode 1.8mm
st elevation 0 episodes
please someone help me to understand it
thanks in advance

[Stephanie71083]

Thanks for the help!!!

I have an appointment with the cardiologist tomorrow for an echo-stress test. I will let you know what comes of it.

[is_something_wrong]

I'm a bit confused here, about how much we, as we're not doctors, should comment on EKG results (help me out a bit here, Itdood :)

Anyway, what I would comment:

1) You have a LOT of PACs! They are almost always benign, but in such high numbers they appear to be bothersome (if you notice them). Do they bother you? Are you on any meds to control PACs? Short atrial "runs" are almost always benign too, but, of course, 3.500 PAC runs through 24 hours is a great number.

2) Your PVCs are truly nothing to worry about. 237 PVCs are a low number. Your 8 beat run is not ventricular tachycardia, it's IVR (idiopathic ventricular rhythm), implying your lower heart chambers (for some reason) takes over the pacemaker function for a while. If it happened during sleep, it's fairly normal. The 3 PVC run is pr definition NSVT, but it happened at a very slow rate, and by some definitions, the line between accelerated IVR and VT is drawn at 120 bpm.

Pauses longer than 3 seconds (during sleep) and 2,7 seconds (at daytime) are usually considered abnormal and should possibly be investigated. There is a possibility you had a third pause, where the IVR  "kicked in" as an escape rhythm, but this is just speculations. It can easily be seen on the monitoring.

I agree with Itdood, you should stay in touch with your cardiologist and ask what tests you should do in the future. Most likely though, this is not dangerous, just some irritable spots in your heart.

[itdood]

Here are the things that stand out:

The 288 isolated ventricular ectopics are PVCs (premature ventricular contractions).  That's not a lot of PVCs for 24 hours.  The 2 runs are called none-sustained ventricular tach or NSVT.  That's not a lot.  
THat gets us down to the supra-ventricular ectopics.  These are called PACs (premature atrial contractions).  You had a lot of those.  16% of the your overall heart beats were PACs.  There were a lot of runs there.

I'd rather have a lower number of PVCs than PACs (which you do) because the ventricles have a lot more muscle and a lot more pumping power than the atria.  The PVCs will probably feel like really hard thumps where PACs are more of a light flutter.

By itself the holter can't paint a complete picture of your heart health.  I think it warrants more tests.  Things like an echo and stress test then go from there.    Follow-up with your cardilologst and get the next set of tests. That will determine the next move.