the cause?

[Wubbie1]

Hi, I am a 36 (almost) year old stay-at-home mom with 3 kids. In May 2011 I had a few moments of rapid heart rate, lasting seconds, and it seemed to stop. Then in Sept I had 2 times where it lasted 2 hours at highest 171. I have not had it happen at all since Sept 21. I did a 24 hour holter which showed nothing except early heart beats. Thyroid is fine despite being enlarged with nodules, the levels are fantastic. I am awaiting adrenal testing. My PCP wants me to do a 2 week monitor, starting today, but I wonder if I should go to a cardiologist first. Can the early beats cause moments of rapid heart rate that can last 2 hours?
Thank you!
Meg

[Wubbie1]

Thank you. The times that I did feel it, I was not doing anything. One day I was getting  kids ready for school and the other standing around talking with moms at a playgroup. Those two times it lasted 2 hours.
Very interesting, it seems that the 2 week would give more info if the high heart rate occurs again. UGH!

[tom_h]

I noticed above that you reported your heart rate at 171.  As I indicated, that would be on the very lower end for it to be SVT.  A certain symptom of SVT is it starting and stopping in an instant.  It doesn't ramp up and down like your heart rate does while exercising.  If you have this characteristic symptom, your problem is probably SVT.  There are a number of different kinds of SVT, practically all of them are non-life threatening in nature provided they don't last for hours at a time, and you are of reasonable health.  I had 54 years of episodes, and still managed to compete on a high level at speed skating, track cycling, and surfing.  So it's not something that will impede your life a great deal, but is a pain to deal with when it pops up.

[tom_h]

I'm certainly not an expert, but from what you posted, it appears fairly normal.  The "tachycardia" is sinus in nature, and it could have been from running up a flight of stairs, or any exhertion that would raise you heart rate.  SVT on the other hand starts and stops abruptly, and has a lower limit of perhaps 180 (it can be lower) and has an upper limit in the lower 300's.  Low 200's seems to be the average for adults with the higher rates reserved for kids.  I was 6 y/o, and was clocked at 312; that's rippin'.

When you get your long term, wear it religiously, and do the things that you normally do.  Hopefully, you'll be on your way to a diagnosis and a control or perhaps a cure.  It looks like your professionals are taking all the right things to find a cause.  Once those things have been ruled out, they'll look at the possibilitiy that your heart is "wired" incorrectly, and perhaps suggest medication or an electrophysiology procedure to find the root cause.

[Wubbie1]

Oh, forgot to add that it said predominant underlying rhythm was sinus.

[Wubbie1]

Hi everyone, thanks for getting back! I picked up my holter results. I had to reschedule the 2 week monitor till next week. I was a bit worried because we have a scout outing and I may need to attend and next week looked better. But, here are my results, if you could help me figure them out, I'd be so appreciative.

Avg heart rate 79 beats per min
Min heart rate 49 beats per min at 10:17pm
Max heart rate 136 beats per min at 6:06am

Ventricular ectopic activity consisted of 396 beats of which 10 were couplets, 385 were premature ventricular contractions and 3 were single ventricular contractions.

Rhythm included 1 min and 5 sec of bradycardia with the lowest single bradycardia occuring at 3:51am and lasting 5 seconds with a min heart rate of 50. Rhythm included 3 hours and 43 mins and 51 sec of tachycardia with the fastest episode of tachycardia occurring at 6:05am lasting 1 min and 43 sec with  max heart rate of 136.

Supraventricular tachycardia ectopic activity consisted of 74 beats of which 58 were late beats and 19 were single premature atrial contractions. The longest RR interval was 1.5 sec occurring at 9:39am. The longest NN interval was 1.4 sec occurring at 2:54am.

impression 1) normal holter monitor, 2) symptoms do not correlate with underlying arrhythmia.

So it sounds like this is normal? I thought that SVT and PAC can cause rapid heart rate or feel like rapid heart rate?

Sorry for the LONG, LONG post.

[tom_h]

"Early beats" can initiate SVT.  It was explained to me simply as everything lining up at the precise monent. If the electrical pulse arrives late, or early nothing will happen.

A "long term" monitor will be your best be to catch paroxsysmal events.  The recorder is a simple 2 leaded device with leads that snap onto user replaceable sticky pad electrodes.  The only time it is not worn is for showering or bathing.  The wearer calls a monitoring lab and downloads any recordings that occur.  It's very easy to do.  Most labs supply a return mailer for the device,  So when you're done, take it off, place it in the envelope, and drop it in the mail or any of the express shipping services.

[ireneo]

The long term monitor will give them a better chance of catching the fast rate. Do you know if there is some specific trigger for the rate? For me it's being stressed, tired, eating too much chocolate, moving too fast, etc. I have PSVT which is a type of tachy that starts suddenly, runs for a bit, then stops suddenly. Harmless but annoying. You don't have to see a cardiologist to wear a monitor. The monitor does the work. If there are questions about what they see, they'll send it on to a cardio. Hope you get some answers.

[dolphin8808]

Hi there!

I think the 2 week test is an excellent idea. I had to do a 30 day test to catch mine.

What kind of early beats are you having?  If you are having simple PACs or PVCs, then something else is causing your high rate. You may have a tachycardia of sorts.

Going to a cardio is not a bad idea either, they will probably though do the same kind of long term monitor to try and catch your symptoms.