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502685 tn?1212808619

Holter Monitor Results

Hello, Doctor...

I am a 44 year old woman who had a holter monitor test for heart palpatations, which I have had for a couple of years but have increased in frequency in the last 6 months.  Here are my results:

General
109769 QRS complexes
0 paced beats (<1%)
2823 Ventricular beats (3%)
4 Supraventricular beats (<%)
0 BB beats (<1%)
0 Junctional beats (<1%)
0 Aberrant beats
0 % of total time in AF/AFL
100 bpm), 12% total
13251 beats in bradycardia (<60 bpm), 20% total
1.36 seconds Max R-R at 05:33:14


Supraventriculars (S.J.A)
4 Isolated
0 couplets
0 bigeminal cycles
0 runs totaling 0 beats

Recommendation from reading cardiologist, "This appears to show recurrent episodes of nonsustained ventricular tachycardia which are symptomatic.  She will require a referral to an arrhythmia specialist and need an echocardiogram to determine her left ventricular function.  In the interim if there is no contraindication to beta blockers, you should consider starting her on 25 mg PO BID"

I am now taking Metroprolol as prescribed, and I must say when I remain calm, it really seems to help, but some days now I am worring myself sick.  I tend to breathe shallow and I do get short of breath with the palpatations.  Seems when I can keep myself calm none of this is an issue - but when it happens I worry which makes it worse - a vicious cycle.  I am an active, busy mother of two and now I seem to stress about this constantly.  I have an appointment for the arrhythmia specialist for June 10th.  Please, can you tell me if I should be this worried? I am very worried - it's some days all I think about.

Thank you.
~Karen
30 Responses
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230125 tn?1193365857
MEDICAL PROFESSIONAL
I agree with the recommendations and wording of your cardiologist.  It is probably nothing to worry about, but there are additional tests like an echocardiogram that will help determine if there are any risks.  The most important information that is needed is if you have a structurally normal heart  -- the echo will answer that.

If your cardiologist was worried, he would have called the arrhythmia doc and scheduled you the next day or admitted you to the hospital.  The fact that they didn't do these things suggests that they think you are low risk.

Helpful - 1
Avatar universal
A related discussion, Holter moniter report remedy was started.
Helpful - 0
502685 tn?1212808619
Can I ask, Dr., (I don't know if you revisit these posts, but thought I'd take the chance)...if my palpatations go down to nearly nothing when I am relaxed or distracted, would they likely be stress as opposed to something structurally wrong with my heart?  I am thinking, if it was a structural problem causing the symptoms, wouldn't the palpatations be there pretty much all the time (like a broken wrist causing pain because of the broken wrist)? Thanks! ~Karen
Helpful - 0
502685 tn?1212808619
Regarding stress and "strengthening" the PVC reaction - or maybe defaulting to the PVC reaction, I think that yes, my nervous system reacts to stress with PVC's by default.  And it's not always even conscious stress, but when I'm having a lot of PVC's sometimes I think, okay, what am I doing that I don't want to be doing, and it's always something that subconsciously is making me uncomfortable.  Even if it's something I enjoy, but something that in some way makes me nervous, say, before a more challenging horseback ride, by default, I don't get for instance, a headache, or a stomachache, I get palps.
Helpful - 0
Avatar universal
To answer an earlier question you had, I am mid-forty, and I do believe hormones play a role, at least in my case, in increasing the frequency or the force of sensation of the pvcs. I've had them for about 27 years, they just seem so much worse now.

I am one gal, who, despite all else that menopause may bring, am looking forward to getting it over with.

And thank you for your kind words earlier. A sense of humour is a good thing to have in anybody's medicine cabinet--it can relieve a lot of things.

One last point I'd like to make or explore with you all, is the connection between stress and actually strengthening the pvc reaction. Do you think that, over a life-time of stressful events it can cause the heart to respond in a certain way. I mean, much like developing a callous if you do hard work with your hands?
Helpful - 0
502685 tn?1212808619
You have a very, very good attitude Upbeat - even your name shows a good attitude.  I think I range more in the 1000-2000 per day range, I'm not sure because I was having a good day during the holter test before I panicked.  But it's the bouncy-all-over-the-place, make me breathless ones that get to me.  And to pvcchick, even days when I get few for me, it's still the bouncy ones that get to me if they are 5 or 10 or whatever, I agree they all feel terrible and unnerving. I am tired of them being the first thing I think of when I open my eyes in the morning, the last thing at night.  I love my life and it consists of so much more than these things.
Helpful - 0
Avatar universal
1, 10, 100, 10,000 it's all the same when it comes to pvcs. They feel terrible, they are scary, they can take your breath away, make you feel lightheaded, they can be life changing.

If I can keep the thought in my head that they won't hurt me, I can get through most days. Other days are difficult, but I'm still here. Sometimes I feel very strong as a result, like nah-nah-nah-na-nana you haven't got me yet. But mostly it's one foot in front of the other and therefore when I see clear to do it, I really really enjoy the things I have in my life. I am very much a "live in the present" type of person if I'm not focusing on the pvcs at that moment lol.
Helpful - 0
Avatar universal
I'm with you Upbeat.  I am honestly starting to believe they must be benign and as well after 20 years.  I totally agree anxiety and obsessing about your heart makes it 10X worse.  You are totally right about being strong willed though.  It has been a tough road with these things.  I still don't understand how you can cope with that many PVC's a day though.  I am trying to deal with 10ish!
Helpful - 0
Avatar universal
well, I get around 30,000 pvcs/day, but only feel a couple of hundred, lucky me.

Mostly it's when I'm at rest.

I usually have no problem falling asleep, but if I wake in the night or early morning I feel every single one of them. Thump, pause, thump, pause flutters, you name it. It makes it very difficult to go back to sleep because in order to stop focusing on the pvcs, I start to make lists for the upcoming day. What a way to start, huh.

Since I've had them for about 27 years I'm sure they are benign, I trust the cardiologist and E.P wouldn't let me walk out of their office if they thought otherwise. But the coping is sometimes an issue. Anxiety and stress from every day life can make them worse, and then when you notice the pvcs that adds more anxiety and the spiral begins.

It would appear that people who notice their pvcs may be more sensitive, but I believe they are the strongest willed people on the planet, you've got to be to keep on living and not let the pvcs condemn you to a life of misery.

Helpful - 0
Avatar universal
Hi there.  Yup do you know that it was  this forum and what the doctor on here was saying about the anxiety issues and us type of people not wanting to take anything.  I hated taking anything more than an Advil so it was a huge step for me asking for something to take my anxiety down to a manageable level.  I feel I am almost there though.  

Just out of curiousty when people say (like cabkrun) that they get palpitations do you mean the type where your heart just start going fast or do you mean the type where you actually feel it going totally irregular?  I don't even care when I get the fast ones.  It is the skipping and thumping around that scares the hell out of me.  As I say though, I usually only get around 10 a day and it looks like so many more people get a lot more.
Helpful - 0
502685 tn?1212808619
Hi!
I actually think that I got in reasonably quickly considering, and I love my GP, I became her patient many years ago and she's a rare treasure.  The wait time only seems long to me because in this situation it would be so much nicer to know right now. Having said that I'm also pretty grateful I'm not being rushed in!

I really enjoy this doctor, I completely agree about reading his posts...my absolute favorite is what he said about being anxious about or resistant to taking meds for PVC's which I absolutely was...he said, "I think that people afraid to take medications to treat the problems that are meant to treat the problem that they are afraid of (that is a mouth full) tend to have more anxiety issues.  Anxiety, as you know, is very difficult to treat."  I had to laugh! Sums it up pretty nicely!
Helpful - 0
Avatar universal
Hi there
I think all the comments here are great. It sounds like you are going to be fine.  I've had PVC's and never dropped over dead, even getting the heart rate over 180.  

Hey, in terms of waiting tho, there are very often wait times here in the States too... for specialists absolutely.  I've waited a month or longer to see specialists, and that's in an area over flowing with doctors... so don't feel so bad about your health care system or waiting even.  
Helpful - 0
Avatar universal
Hi there again.  So true what the doc says about seeing numerous specialists and them finding nothing wrong.  I am 47 years old though.  As I say it has been many many years that I have been freaked out about this and I am trying my damdest to get over it now and move on.  This doctor here on the forum has made me feel so much better when I read some of his postings.  Is it true, true, true, what is says.  I know he says a lot about anxiety disorders and irregular beating and I believe it is true.  I know mine started one day when I was very stressed and they came on full force after that.  I probably did have then prior to this but I maybe just didn't notice them.  Once I knew what my heart was capable of doing I think I put myself into a complete rut.  As I say it has been 20 years of worry over this and I am so tired of worrying about it.  Keep us posted on how you are doing!
Helpful - 0
502685 tn?1212808619
Hi!  Glad to see you back - I am so pleased with these ladies, I feel a lot better - thank you for your answer too, and as I said I would give anything right now to hear "benign!" ~Karen
Helpful - 0
502685 tn?1212808619
Thank you so much you two...you are making me feel a lot better.  I called my GP's office this afternoon to see if it was possible to get the echo before my specialist appt on the 10th of June, and they said that it depends on an opening and the hospital will call me - there's only the one that does echo's in Winnipeg.  I have been so focused on these things since the holter report, and before that I actually nearly cancelled the holter because my heart was being so quiet, I kept the appt for the holter because I had already waited so long I figured what the heck, better get it over with already - I was that blasee...and then when the cardiologist said wait, we better look at this in more detail, well now it seems to be all I focus on.  Bring on the prozac - seriously - I could do with chilling out a bit over all this.

Can I ask your ages?  Because I wonder sometimes if peri-menopause contributes to these palps...hormones and all...
Helpful - 0
230125 tn?1193365857
MEDICAL PROFESSIONAL
thanks for posting.  thoughts like those are very help to people struggling with the same problem.  The problem that I see repeatedly is that people are convinced that they are going to die despite reassurance sometimes for 3 or more specialists.  No one denies the PVCs or that they are scary, it is often how you cope with them that determines quality of life.  It is tough battle.
Helpful - 0
Avatar universal
Yup wait times are horrible in Canada but at least they are free.  That is nuts the amount you have to pay in the States.

Bondieluv I can make myself have tons of them when I stress as well.  Actually one of them usually sets me off into a panic attack and then I can have multiple ones.  I know it sounds crazy but true!  I guess I am just super sensitive to adreline.  

I can almost guarantee you are in the same boat as us.  It sounds exactly what I get.  I can't tell you how many cardiologists and EP docs I have been to.  The last EP doc I saw at the Foothills Hospital here in Calgary said that it was my reaction to the PVC's that was abnormal, not the PVC's themselves.  They said I should see a shrink which I did and it calmed me down a bit (temporarily).  Anyways I told them that I didn't have anything wrong with my head, it was my damn heart!  I thought for sure they were missing something.  I couldn't understand how a normal heart would carry on like this.  I actually just had one about an hour ago (I am at work right now), and it kinda flutters for a few seconds and stops and does a bang.  I really think I am not being bugged so much about them now since on the Prozac.  It has been a LLLLOOONNNGGGGG road but you will no doubt have the same diagnosis as me and the rest of us.  Keep us posted on everything!
Helpful - 0
Avatar universal
I used to live in Canada. I can't believe the wait times now for most things there. 15 years ago, after struggling with pvcs for years previous, I saw a very sympathic and understanding family physician, she ordered a holter, stress-test and referred me to a cardiologist for the pvcs it seemed like it was all within a week. But times have changed haven't they?

There is a trade off for faster health care here in the U.S. unless you have cadillac insurance coverage. I have insurance coverage but it has a $2500 deductible before they pay anything. So the echocardiogram was $725, the cardiologist visit was $500, and the event monitor was $635. Now that's enough to cause anybody pvcs!

I hope your wait isn't too long. Have they been able to give you a specific date?

Hope you are able to enjoy an nice long weekend--Victoria Day, and not be too bothered by pesky pvcs.
Helpful - 0
502685 tn?1212808619
Thank you, what you wrote is very, very reassuring - and yes, stressing out about these things does make them a million times worse.  During my holter monitor test, I was at about hour 22 and nothing significant had happened, and I started stressing about oh no, what if this thing doesn't pick anything up - and WHAMO all of it went off, the palps, runs, lightheadedness, shortness of breath, just like a party for an hour - so I knew for sure they got all I could give them to look at...

What scares me is that these last PVC's etc have become "symptomatic", I do get the breathlessness mostly but that's new in the last 6 months or so.

I so would love to hear benign.  Would do about anything to hear that right about now!  
Helpful - 0
Avatar universal
Had it all Bondieluv.  Had holters, echos, stress test - you name it I have had it.  They can't find a thing wrong with me.  They say everyone gets these things and to not worry about it.  I have had them for over 20 years and still cannot get used to them.  They just feel so awful even if they are benign.  Believe me, worry makes them 10 times worse.  I can actually make myself have them just by thinking about them and stressing.  

You are probably in the same boat as the rest of us and they will just tell you - benign, benign.  I am so sick of hearing it.  I guess we just have to somehow, someway learn to accept them.  I actually say that since I have been on the Prozac my anxiety level has gone down tremondously about them.  

If you have had the holter and they didn't call you right away about it then you are I am sure fine.  I had an 8 beat run of NSVT that they called me in to the hospital for on my first holter and that is when they did all the tests on my heart and said it is fine.  I had returned the holter at 2:00 p.m. on a Wednesday and the emergency department called me at 9:00 a.m. the next day so they don't make you wait if it something serious.
Helpful - 0
502685 tn?1212808619
So have you had the holter monitor and echocardiogram and etc?  I really have been nervous lately and waiting is the very hardest thing, not knowing if I should worry as much as I am doing, which of course makes it worse.

We didn't have a lot of snow this year but man was it cold!!! I'm not in Winnipeg, we're about 1 hour away just the other side of Stonewall in a village called Balmoral.  Population maybe 200 on a good day, less when they head out on garage sales!! lol
Helpful - 0
Avatar universal
Yup, they can't find a thing wrong with me but I sometimes skip all day.  They have seen couplet PVC's triplet PAC's but I am the same as what Upbeat posts.  They always tell me I am normal but I beg to differ.  Those cardiologists must all say the same thing then because I heard the same thing from mine. My PVC issues have been going on for 20 years or so.  PS - Iived in Winnipeg when I was a little girl - I remember a ton of snow!
Helpful - 0
502685 tn?1212808619
Hi there!  I'm in Manitoba, the cardiologist was at the St. Boniface Hospital in Winnipeg.  Do you have on-going issues with PVC's too?
Helpful - 0
Avatar universal
Just out of curiousity which Province in Canada.  I live in Alberta and they are opening up a special heart hospital in Edmonton that I am looking into.  Funny thing the cardiologist said you would live to be 100.  So did mine.  Wonder if it the same one?
Helpful - 0
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