Holter monitor results.. opinion.

[guinea54]

A couple of years ago I went to the cardiologist pretty convinced I was having some kind of heart arrhythmia like SVT or something.  Long story short, he gave me an EKG,  echo, and a holter monitor..  EKG said something that I noticed , incomplete right bundle branch block.. He said everything was normal..  Echo.. he said everything was normal and that I had a strong heart.   Holter-  I had an episode wearing the holter monitor..  was shocked when he told me that the holter results were fine, that I had a panic attack.. So thus sinus tachy, no SVT ..   I found it really hard to believe.. The women who put the holter monitor on me had the leads in a line going under my left nipple area..  I was thinking maybe it wasn't set up right?   I called the doctor about it, and he just said the machine got a good read.  
    Am I being paranoid and should just accept those results..  I'm thinking about it now because the heart racing at night started happening less and less frequently.. and when it did, i felt like it was way more controllable.. Id feel that feeling and try to cool off and relax and sometimes it would be a mild increase in heart rate then stop.. or something it would race for every little and stop.. They just weren't as severe anymore... Now after taking lexapro 5mg for two weeks.. I been getting the attacks again at night but stronger and harder to control.  It brought me back again to all this fear and worry over SVT..
    Sorry for the long post..  Just curious what people think... I wonder if Lexapro has a negative effect on the heart rhythm. . or its just a side effect of increasing my anxiety

[tom_h]

guinea54, has anyone described to you what SVT feels like?  This could help you dealing with your issue.  The hallmark of SVT is that it begins and terminates abruptly. It doesn't slowly ramp up in speed and then ramp down.  It starts and stops on a dime, and is usually easily felt.  When you dropout of SVT, there is a sudden stillness within you and this is as noticeable as when it starts.  Heartrate while you're in SVT is usually quite repeatable from episode to episode.  You wont find much differences in beats per minute unless it occurs while you're under heavy respiration such as working out or exercising.  Typical SVT and rates range from 160bpm on the low end to 260bpm at the high end.  Your rate would typically be within that range and repeat that rate from episode to episode.  As a 6 year old, I was clocked in the hospital as 312bpm.  As I aged, that rate slowed to about 220bpm as rest and about 250 under high physical demands; not much difference.  I hope that helps you dealing with whatever you're experiencing.  Just a cautionary note with SSRI's and SNRI's.  They have their own setnof problems.  Getting off of them is often very difficult with wild mood swings and "brain zaps".  I witnessed this firsthand when my wife was very ill with the flu and ceased her SNRI, Effexor.  She spiraled down to a point where she requested that I call an ambulance to transport her to the hospital.  I made her take half her dose of Effexor to see if she could keep it down, and half a bit later.  Within a hour, she was sitting up and eating for the first time in a couple of days and feeling remarkably better.  The flu  was better.  She was feeling the effects of SNRI withdrawal.  Understand this as you begin this, and never be without it.  Always keep a small supply with you, and reorder before you need it.  Physicians wont often tell you this, and prescribe the stuff like it were Tic-Tacs.  Its serious sh##, and you should know these facts before commencing treatment with them.

[2210485]

If the holter was on when you had an episode then thats what it was.

Straight line under nipple sounds about right, though honestly you can put those leads just about anywhere on your chest and still have a basic idea of your rhythm... Could put one on your neck.. One on your back.. Another on your knee, id still be able to differentiate obvious things like svt, or vtach/pvcs. Id just be missing out on some of the finer details..

Your right bundle branch block is pretty common and not concerning on its own... The left bundle branch blocks are the scary ones.

Of course you can always request more testing.. Theres no guarantee that you dont have atach episodes and also svt.. Though its unlikely in many cases.

2 things to keep in mind..

1. The faster your atria beats the more likely you are to go into svt if you have the pathway. So if youve had severe episodes of a tach on the monitor, with no svt, it lowers the probability of svt a bit.

2. Svt is self terminating, the episodes cant go on forever, though the precise amount of time you experience it will vary from patient to patient.

It really isnt necessarily a problem per se until it begins to impact your hearts mechanical activity, complicated other diseases or until it starts severely impacting your quality of life.

For example many patients with svt are obese, and when they get ablated they lose staggering amounts of weight.

This is because the svt was actually limiting their physical capabilities and lifestyle choices. Once they lose the svt they're able to get more active and the weight follows. I hear many comments from folks who say things along the lines of "i thought i was out of shape and,my friends thought i was just lazy'.. The reality was, their svt was frequent and severe enough that it was completely ruining their lives for all intents and pruposes. So in cases like this getting svt taken care of is a big priority..


Anyways for someone young and healthy with sporadic episodes, maybe a minute or 2 per day.. (ie the majority of folks who present for avnrt ablations). The risk is low.

Frankly the only reason they fix it as often as they do is because its pretty easy.. Its kind if like the electrophysiology equivilent of removing a wart or something.

What this means for you is even if it is svt chances are its harmless. Just some food for thought..

[guinea54]

Thank you for taking the time and answering my post.  I appreciate it.  You sound very knowledgeable on the subject.  I guess if the monitor didn't pick up SVT than perhaps it was never SVT because I believe I got a pretty bad attack while I was on the monitor.  My heart was racing like you wouldn't believe.   Usually its been controlled.. I feel like the attack is coming and then i only get it a little and it settles down.. sometimes it gets worse but settles quick and other times i feel like i lose control and the heart just goes totally insane.