Skipped Beat During Stress Test

[bluebird9197]

I had a stress test done.  I've been sedentary for about a year now because I've been afraid of provoking my SVT.  I've been getting feelings of skipped beats so my doctor had me do an exercise tolerance test.  I was only on the treadmill for a couple minutes when I reached my target heart rate.  The tech had me keep going and sped up the treadmill.  I felt fine.  My heart rate reached into the mid to upper 170's.  I felt a skipped beat and saw it on the monitor.  But the printout didn't catch it.  The cardiologist said the printout just showed normal sinus tachy.  I was on the treadmill for four minutes. I got scared and had them stop the test. Isn't the monitor supposed to catch abnormalities for the printouts?  

[tom_h]

Assuming they're PVC's or PAC's, I wouldn't call them normal. But most of them are harmless, the equivalent of a muscle twitch.  Chains of them are a different story.  But an occasional one is usually no problem.  Of course your cardiologist would be the one to judge.

PVC's often go hand in hand with PSVT.  Electrical signals have to occur at precisely the right moment to trigger a SVT.  The 3 SVT events that were captured on my 30 day event monitor all started with a single PVC.  I never felt it because I guess I was startled by the sudden racing.  Interestingly, as I aged, my SVT events swinged from occuring during high physical demands to perhaps just watching TV or dining.  The jump from 70bpm to 220bpm in one beat is more startling than when going from a sinus rhythm of 180bpm to an SVT rhythm of 220bpm.  

Do I think you're silly?  No, of course not.  It's too bad that only a technician was there with you.  A cardiologist may have given you reassurance that you were fine and that more data was needed.

May I suggest something?  This is assuming that you've been given the go ahead by your physician to exercise.  I don't know how long you've had it.  This is coming from 54 years of SVT; 6 to 60.  Hopefully, you have been trained in countermeasures to terminate it.  If you haven't, then you should ask.  My SVT was a self sustaining kind, meaning once it started, it never terminated until I intervened.  For me Valsalva worked, and I never had to make a stop at an ER for medical intervention. Don't let SVT control your life.  Challange it.  Dare it.  If it happens, you know it won't hurt you.  Having a professional witness the event may actually be the first step in either control or cure.  Always here if you got ?'s.

[bluebird9197]

I meant to ask, does that mean the PVCs I'm feeling when I exercise are normal?  Or at least not harmful?  I used to be very active, but in the last five years I've been getting skipped beats and last summer my heart started racing when I was working out -- it jumped from around 150 to 180 -- and I was told it was symptomatic of PSVT.  I've been sedentary for a year now and I want to get back into action but I'm scared.  Am I just being silly?

[bluebird9197]

You're right, I should've stayed on longer.  But I got scared and there was only the technician in the room with me.  She paged the cardiologist at the end.  The last time I had a stress test done, it was at a different facility and they had 4 people in the room that included two nurses.  I think I was partly feeling a lack of trust too.  The PVC didn't show up on their printout though.

[tom_h]

If I were you (and I was, sorta), I would have kept going.  This is precisely the location where you would want to provoke non life threatening SVT.  That event would have proved extremely valuable in treating your condition.  This was your chance to literally show them what you're feeling, but you punched out early.  Unfortunately, it sounds like the test revealed only a couple of PVC's or PAC's.  If you felt it and it was on the monitor, it caught it.  A PVC thrown here and there is really no biggie.  If you ever get the opportunity to do it again, stay on it until you feel like you're going to go flying off the back of the treadmill!  I had the advantage of having my cardiologist standing right next to the treadmill watching the screen.  If I was going to crash, who would I want most standing next to me? 8-)