Holter Monitor Results Decoded?

[shellydianne70]

Hi...I will be 40 in less than 2 weeks and have been sick much of my life because I was born with an immune deficiency. But I have always had a healthy heart....I wish I could say that about my lungs.

About 3 weeks ago I begin having a very regular feeling of my heart pounding, fluttering, even contracting sometimes like the whole thing was clentching at once.

I had a 48 hour holter monitor which I got the results of and my general practioner is referring me to a cardiologist. I left his office with a copy of the holter monitor report and it seems scary and confusing.

Can anyone help if I post the details?

It seems like SVTach runs: 478 is a really bad thing?!!?

Help??

Shelly

[shellydianne70]

Good morning itdood and ireneo,

itdood...thank you for the very common English explanations of my holter monitor terminology. I feel less anxious about waiting a month to see the cardiologist/electrophysiologist.

ireneo...my Mean SVE/Hour: 350.7...so your math was correct...5 or 6 per minute.

Again...thank you to you both!

Also...I just noticed today is wear National Wear Red for Women day to bring awareness to heard disease for women. I am sporting my red sweater!

Have a great day...I will be keeping up on the posts of others (especially women with heart problems) on medhelp.org. I am very glad I found this community!

Shelly

[ireneo]

Itdood explained it all very well. You are having tachy bursts, that is very short runs of atrial tachy but they're not dangerous. My heart does that now and I'm considered "cured" after my ablations. You had quite a few atrial ectopics (I call them heart hiccups). I see in one minute you had as many as 35. What I don't see is a "mean" SVE per hour like they did with the VE's. That would have been nice to know.

If I do the math, divide the total number of supraventricular "events" as they call them by the number of hours (48) and then by minutes (60), looks like you averaged about 5-6 funny heart beats a minute. Sure, they came in clumps rather than being neatly spread out, but 5-6 a minute is not real dangerous either.

The waiting is always hard. And when you do finally get in to see the cardio, have your list of questions ready. Don't be afraid to press until you understand what's going on. Some doctors just rush through, tell you you're normal and fine, get a life. Don't settle for that. I'm not saying you need treatment but you deserve some clear answers.

[itdood]

Hi Shelly,

Yep, that's a lot of flip flopping going on.

Rate dependent event:
The Bradycardia is a slow heart rate.  This means less than 60 beats per minute.  Your lowest was 56.  This is not uncommon.  On a scale of 1-10 I'd rate your brady as 0.

Ventricular events
These are probably premature ventricular contractions or PVCs.  I would rate the amount you are getting at about a 2.  PVCs will make your heart feel like it flips flops and cause a pause in the HR which is just compensating for the early contraction of the PVC.  The couplets means two PVCs in a row, you will really feel this, it's a huge thump.


SUPRAVENTRICULAR EVENTS
This means everything else above your ventricles, meaning the atria.  These are probably premature atrial contractions, or PACs.  You are getting a lot of these + many couplets (2 in a row).  On a scale of 1-10 I'd rate it at 7.    Some of these are sneaking their way through your AV node to the ventricles causing a fast heart rate in very short runs.  The longest being 25 beats in a row, which meant it latested around 6 or 7 seconds.    The tachycardia events happened 478 times during the time you were wearing the monitor.

These ectopic events a.k.a premature contractions are caused by backup pacers cells in the heart muscle.  These are there for backup, but for some reason yours are firing wen not needed, especially in on of your atriums.  The ectopic beats are finding their way into the ventricle.

What is causing these will need more advanced tests to figure out.

The reason your are not getting the cardio right away is because you are not considered to be in urgent need of medical attention.  If your doc felt differently you'd be moved to the front of the line.  If you feel this is bad decision, call up the doc for an escalation.

Some of the possible root causes are

Endocrine
Structural changes in your heart
coronary heart disease
Autonomic nervous system

many different issues for each of those categories.  It will take some testing to sort out, if it were me I'd want a cardiac MRI to be sure no structure issues or CAD.  best of luck.

[shellydianne70]

Thank you so much for just reading my post.

The report is complicated and while anyone with some web skills can get definitions for all the terms and abbreviations, it really doesn't tell you what it all MEANS.

I have an appointment with a cardiologist who specializes in electrophysiology on March 8th. Just knowing I need to see a doctor in such a field is scary!

The 48 hour holter monitor was broken into three primary categories:

RATE DEPENDENT EVENTS
     - Bradycardia runs: 13
     - Lowest BPM: 56
     - Max BPM: 150

VENTRICULAR EVENTS
     - Total Beats: 167
     - %  Beats: 0.07
     - Couplets: 4
     - Max VE/Minute: 3
     - Max VE/Hour: 12
     - Mean VE/Hour: 3.5

SUPRAVENTRICULAR EVENTS
     - Total Beats: 16832
     - % Beats: 7.41
     - Couplets: 1784
     - SVTach Runs: 478
     - Longest: 25 beats
     - Max Rate: 196 BPM
     - Max SVE/Minute: 35
     - Max SVE/Hour: 670

I really don’t know what most of it all means together…except my heart rhythm is all out of whack…that is my professional terminology. :-)

I hate waiting another month...but I am trying to trust my GP and believe if it was more serious I would be getting seen faster.

Thanks,

Shelly

[ireneo]

Is the 478 the heart rate or the number of SVT you had while wearing the Holter?

If the heart rate is 478, you know that's not normal. It could be atrial flutter or fibrillation. They'll probably want to put you on medications to help with that.

If it's the number of SVT runs in 48 hours, that's quite a few and again, they'll probably want to intervene with medication.

The reports says "runs" but if it was some kind of ectopics and you had 478 in 48 hours, that's not bad at all.

I hope you're going back for a follow up visit to get this cleared up and find out what they want to do next.