Holter Monitor

[TJ1966]

42 yr old female - 4 kids - irregular heartbeat (PVS's diagnosed at age 17 - by several EKG's, echocardiogram and continual EKG monitoring while inpatient for 2 days) - have had 3 holters since 17 - each showing PVS's bigeminal fashion.  Echo at that time was completely normal.  Most recent 24 hour holter (6 weeks ago) shows:  Ventricular Ectopy - 4 Total, Supraventricular Ectopy - 2,436 total, Sustained SVT greater than 150 - 2 total, Sudden increases - 44 total and sudden decreases - 14 total.  Min Heart rate of 50, max of 164 with an average of 85.  States:  (1) Rhythm is Sinus with 1,206 pauses less than 2.5 seconds and sustained S. Tachycardia (Max HR 164 bpm -occured at 8:14 a.m.)  (2) Rare VPB's were observed, (3) Frequent SVPB's were noted.  My GP sent me to cardiologist - he didn't seem concerned....I go for a echocardiogram in 3 weeks.  He is going to request the strips to review from the holter as he only has the report to review.  He said my physical exam today (listened to my heart, my neck, etc and did short baseline EKG) was normal and if nothing "funky" shows on the strips or the echo that I am normal and fine.  I'm concerned - aren't the Supraventricular Ectopy of 2,436 high?  Aren't the pauses of 1,206 high?!  I'm really freaking out about the pauses in particular.  I don't experience any dizziness, shortness of breath or other symptoms that I am aware of when these occur.  He didn't do a chest x-ray today bc I just found out I am pregnant and found out (unexpectedly) last week.  I'm really worried - wondering if these are at all possibly normal?  I do tend to be a little anxious from these skips and pauses.  My BP is normal.  My cholesterol is normal.  My thyroid was within normal range.  I guess I'm just plain scared!  Thanks, in advance!

[Michael J. McWilliams, M.D.]

Take a deep breath.......
The keys statement you made above is that you have no symptoms.
If you have normal heart function and a normal EKG, there is nothing to worry about based on that holter report.  4 PVCs is normal.  yes it is a lot of supraventricular beats but this does not adversely affect you longevity or you symptoms.  If  you are asymptomatic, there is much more you can do to feel better.

I am not sure what chest xray would show if the questions is about extra beats.

I would be more concerned if it read pauses great than 2.5 seconds, it read less than 2.5.  Based on their reading, this is nothing to worry about.  The prooof is in the pudding -- I would need to see the strips, but this interpretation does not concern me at all.

I hope this helps.  Sounds like your real stress is the soon to be 5 kids......


I hope this helps.

[TJ1966]

Thanks for  the quick response!  If the supraventricular beats are "early beats" - does that mean the "pauses" noted on the report could be measureable pauses after those early beats?  Or, would the pauses be independent of the beats?  

I still haven't wrapped my head around the pregnancy - my children are 23, 19, 16 and 10.....I thought I was done with that stage of my life!  Obviously, a large part of my concern is wanting to know the status of my heart health - especially since pregnancy is an extra workload on the heart - and I would rather know if I need to terminate now as opposed to weeks and weeks later.  

Once again, thank you so much!  

[Jules310]

I was diagnosed with SVT when I was pregnant, and it was made worse due to the increased blood flow and workload of the heart during pregnancy.  I was put on a beta blocker, which helped a lot, and posed a very low risk to the baby (low birth weight, and low blood glucose levels are a possibility, but my daughter was fine).  If your EKG and your heart structure and function are normal then you don't need to worry!  No need to think of terminating the pregnancy.  The worst part of it all is the anxiety it can cause you when you have symptoms, or even just worrying about it.