holter results for 9 year old are they normal

[arv99t]

These are results from my 9 year old sons holter. Our pediatrician couldn't decide if we should or shouldn't be concerned. They are sending us to a pediatric cardiologist on 12/22.  I'm looking for some advice on what ?s I need to ask. Also what concerns I should have with these results.

Heart Rates
Min 52BPM
Max 185BPM
Avg 86BPM
Bradycardia Runs 1566
Longest 4617 beats Min
Rate 44BPM (correct me if this doesn't contradict the min of 52 above this confused me)
Pauses0
Percent AFIB 25%

Ventricualr events ( I am leaving out everything that shows zeros)
Total Beats 1
Forms 1
Max VE/Minute 1 beat
Vax VE/Hour 1 beat

Supraventricular Events
Total beats 892
% beats .73
Max SVE/Minute 65 beats
Max SVE/hour 343 beats
Mean SVE/Hour 37.2
SVE/1000 7.3

[arv99t]

The Dr called and cancelled due to being sick. We are rescheduled for Jan 5th

[arv99t]

Again thank you so much for all your advice. I hadn't checked this for a few days due to my moms surgery. We see the pediatric cardiologist tomorrow. I will definitely ask about these things. I'm assuming he may be familiar with these.

[Jeffrey R Boris, M.D.]

You may want to consider discussing with the doctor whether he has postural orthostatic tachycardiac syndrome (POTS), as that can be associated with headaches, passing out, tremors, GI symptoms, and often many other "unexplainable" symptoms.  If your primary doctor is not familiar with this, you should at least learn about it yourself at www.dinet.org or www.dynakids.org.

[arv99t]

I have been researching the elevated vagus nerve tone not knowing what this is. I found some interesting issues he has been having before the passing out started I would have never thought before to mention with this. He has been having some severe stomach pains the pediatrician can't explain. He's also been having tremors in his legs. If the information I have ran across with this issue is correct now I know these things might be worth mentioning. Thanks so much prior to your post I would have never known mentioning other symptoms might be possibly worth it.

[arv99t]

He has been having very severe headaches and passing out. Thanks for your time

[Jeffrey R Boris, M.D.]

Dear Arv,

The normal heart rate range for a 9 year old is approximately 80-135 beats per minute, so a heart rate in the 50's (or even 40's) is certainly low.  However, it also depends on what rhythm is happening at the time of the slow heart rate as well as what he's doing (sleeping, exercising, etc).  If he has exercise intolerance and cannot keep up with other kids physically, this is more of a problem.  However, if he's not aware of it and he's totally asymptomatic, it may be that he has elevated vagus nerve tone, which slows down the heart at rest.  The one thing that's confusing is the AFIB of 25%--not sure if that is really saying that he has atrial fibrillation 25% of the time, or not.  This is something to definitely discuss.  In the end, without evaluating the actual study and waveforms, I cannot say how concerned to be here, although he is likely normal if he has no symptoms.