normal pulse range with holter monitor

[cillakae]

My 11 year old son just had a holter monitor put on today.  His pulse seems to be all over the place (between 58 and 102 sitting down).  Can you tell me if there is a "normal" range for his age?  and is it okay to see it go from 60 up to 90 and then back down to 65 while just sitting eating dinner?  He has felt fine so far while wearing it so I haven't recorded anything yet.  

[Artaud]

Hi,

I'm glad that you are ruling out Long QT Syndrome. I've done the 24 Hour EEG before, I'll bet he wasn't too happy with that. Did he have any episodes while wearing the 24 Hour EEG?

Are there any factors (such as startling) or symptoms that precede the faint?

Best of health to you and yours.

[cillakae]

He is wearing a 30 day event monitor.  It is the type that does NOT continuously record, but it does show the heart rate.  He has it because he has unexplained fainting.  He has seen a cardiologist and a neurologist and has had many tests done so far, including, regular and 24 hour EKG, regular and 24 hour EEG, ultrasound of the heart, MRI of the brain and blood tests.  The cardiologist is thinking vasal vagal syndrome.. I want to make sure and rule out long qt or any other serious heart problems.  I'm not satisfied with "just living with it" when he has such fear of fainting that he has quit sports (which he absolutely LOVES) and is afraid to go to school!!  His quality of life has been affected and he only feels comfortable at home.  I need to feel I have done all I can for him.  If it is just vasal vagal, then he will have to learn to live with it.  Thanks for your reply.

[Artaud]

Hi,

How are you measuring his pulse, does the Holter have a display or are you taking the pulse at the wrist. In either case, the anxiety of observing or measuring his pulse may cause some of the variation. Also, Respiratory Sinus Arrhythmia, the natural speeding up of the heart as we inhale, and slowing down of the heart as we exhale, may account for some variations. Eating dinner may stimulate the Vagal Nerve (see Vagus Nerve on Wikipedia) which may also account for variations in heart rate. Lastly, I would imagine that subtle rhythm disturbances could disturb an electronic read-out.

If you are looking at an electronically determined pulse rate, there is the possibility that the rate is calculated on the time between one complex and the next, and not averaged over a specific period of time, so that slight and temporary variations in rate, perhaps due to the items I described above, show a larger swing in rate than is truly occurring. Take the pulse at the wrist, by hand, for a period of 15 to 20 seconds. Mulitply the results by 4 for the 15 second and by 3 for the 20 second period of time to get the beats per minute.

According to Wikipedia, the normal rates are: For an older child about 90–110 bpm, and the adolescent's about 80–100 bpm.

But this is only approximately, variations in normal abound. If your Son is wearing a Holter Monitor, a 24 Hour recording device, your reference to not having recorded anything yet must pertain to the log they give you to fill-out and/or the need to press the Event Monitor on the recorder when symptoms are felt. Otherwise, every heart beat should be recorded by the monitor irrespective of any action on your part.

But, if he has an 30 Day Event Monitor (or an Event Monitor used for shorter periods of time), you would need to press the button to initiate the device to record the event. This is different from a Holter Monitor.

Why is your son wearing the Monitor? Is he being seen by his Family Doctor or a Cardiologist?

Best regards.