Holter Monitor Results

[Angelika_23]

I picked up a copy of my holter monitor results. It was a 24 hour holter. This is what is says:

"1. The underlying rhythm is sinus tachycardia. There were frequent areas of tachycardia and sinus arrhythmia. Average PR interval 0.15. Average QRS duration 0.10. Average heart rate was 103, ranging from 53 - 163 bpm.

2. The was one premature supraventricular ectopic beat. This beat was felt to be an aberrantly conducted beat.

3. There were no premature ventricular ectopic beats.

4. No AV-block.

5. There were frequent diary entries of "feeling faint", "heart bumped", "fluttering chest", "chest pain", "shortness of breath", "shaky", which corresponded to tachycardia, including maximum heart rate of 163 bpm and sinus arrhythmia."

So, I don't know what the first part of #1 means at all. I don't know what #2 means. I don't know what #3 is, but I am glad I don't have it. Same with #4. And #5 says to me, VALIDATION to my PCP who says there is nothing wrong with me, I just need therapy and medicine. So I guess tachycardia is not an arrhythmia?? This is so confusing...

Oh, and when they did my BP before the monitor, it was 116/82 lying, 150/80 standing and 150/90 sitting.

Any thoughts?

Angela

[tobel17]

I had a similar diagnosis. I was told it was a Sinus Arrhythmia, which is corresponding to the specific area of your heart where the Sinus node is. The sinus node is what controls your natural rhythm.

You can look up more information on similar things by doing a search on Supra Ventricular Tachychardia. Often with SVT there is extra conductive tissue in the heart (it grows naturally) and so when you get stressed, or when the tissue is active (the conductive tissue sends out a pulse to make your heart beat, much like your sinus node) it will make your heart rate go up, because your normal heart tissue is responding to the request to beat. 165 is not a life-threatening speed, but I would talk to your Electrophysiologist about specific questions. I had two ablations done for extra electrical tissue. Cardiac Ablation is often done for SVT symptoms, and its an outpatient procedure. I had a catheter put up through the artery in my leg that goes up into the Sinus chamber of the heart (its on the right side of your body) and they used a platinum-tipped end to heat up the extra tissue. with the tissue scarred (its a very tiny tip) the electrical tissue can no longer put its message out to make the heart beat those extra times. Its an optional procedure. I would recommend talking with your doctor about what exactly your Holter monitor is telling them, and then do some research before deciding on any course of treatment.

Good luck to you

Laura

I picked up a copy of my holter monitor results. It was a 24 hour holter. This is what is says:

"1. The underlying rhythm is sinus tachycardia. There were frequent areas of tachycardia and sinus arrhythmia. Average PR interval 0.15. Average QRS duration 0.10. Average heart rate was 103, ranging from 53 - 163 bpm.

2. The was one premature supraventricular ectopic beat. This beat was felt to be an aberrantly conducted beat.

3. There were no premature ventricular ectopic beats.

4. No AV-block.

5. There were frequent diary entries of "feeling faint", "heart bumped", "fluttering chest", "chest pain", "shortness of breath", "shaky", which corresponded to tachycardia, including maximum heart rate of 163 bpm and sinus arrhythmia."

So, I don't know what the first part of #1 means at all. I don't know what #2 means. I don't know what #3 is, but I am glad I don't have it. Same with #4. And #5 says to me, VALIDATION to my PCP who says there is nothing wrong with me, I just need therapy and medicine. So I guess tachycardia is not an arrhythmia?? This is so confusing...

Any thoughts?

Angela

[morgan617]

Angelika,

1. means you have a lot of fast heart rates...your average heart rate is above 100. A normal person will have up to about an hour of tachycardia in a 24 hour period. More than that is considered abnormal. Sinus arrythmia means your heart is in a sinus rythym, it's just a bit irregular. Most people have sinus arrythmia when they breathe. If you have a pet, put your hand over it's heart and feel it as it breathes in and out, it will likely speed up with inspiration and slow down with expiration. The beats are not abnormal, just not regular..fast then slow then fast then slow. This is very normal. The frequent bouts tachycardia are not normal. The pr and Qrs are just measurements of how long it takes for each part of the beat itself, these numbers are normal.

2. It sounds like you had one PAC, that's a beat that happens before it should, that starts in the beginning of the beat. Premature Atrial contraction...these are also pretty normal, in that every has them once in awhile. It's probably the thump you feel at times. The heart starts to fill with blood and send it to the left ventricle, which shoots it out to the rest of the body. But the sinus node, which initiates the beat, fires before the heart is ready and shoots out too little blood. Then there is a slight pause while the heart resets and that causes the ventricle to get a bit too much blood, so the force it takes to push it out is more. So you don't actually feel the abnormal beat, you feel the beat after that. These are extremely common. In many many people. Beats that occur above the ventricles (the two lower larger chambers of the heart are called supraventricular beats. These are not life threatening, as a rule, but can make you feel pretty crummy. When your rate is really high, starts suddenly and stops suddenly, it is called supraventricular tachycardia.

There are many types of this. Atrial fibrillation, atrial flutter, atrial tachycardia, etc. You had a PAC, which is different than sinus arrythmia. They look different on the monitor, so that's how they can tell the difference.

3. You had no ventricular arrythmias. That is very good. These are much less benign (although you wouldn't think so, the way people here are being treated, that have them) Everyone has these too. An occasional pvc or a fair amount even, if not all in a row, is okay. It's when they run a whole bunch in a row and you have VTach, that you get into trouble. These beats take over the sinus nodes job, the beat is sort of backwards, so no blood can get perfused to the rest of the body. It should go:sinus node to a-v node to bundle of His, which squeezes the ventricles and forces the blood out. pvc's start at the bottom. The fact they didn't catch any doesn't mean you don't have them, but it is reassuring to know that if you do, they apparently aren't frequent. Although some days are worse than others.

4. You have no heart blocks, which is also good. There are many different kinds and most are pretty benign. Some are an indication of heart failure and some of major electrical problems. Some people just have aberrant ones, which they have always had.

Bottom line, you didn't have anything life threatening, but you do have an abnormally fast rate. it could be inapropriate sinus tachycardia (IST) atrial tachycardia, or an atrial flutter that they might miss. Atrial flutter at 150 or so can be very difficult to see or pick up. It can look like atrial tach or sinus tach. Whatever it is, you go way beyond an hour a day, which is abnormal.

Now they need to decide what to do about it. I had ablation too and it was not a good thing for me, so it's something to discuss very carefully with a specialist. it can be a miracle for some and a bad mistake for others. I don't know if you have tried beta blockers or any other meds to control your tachycardia, but that is the first line of treatment.

Apparently your GP is not very open minded and you should get a cardiologist to discuss all this with you. I hope that helps a little. morgan Please excuse the spelling and mistakes, I am a brain fog tonight.....

[flop]

Hi Angela,

don't worry about your holter monitor results - the findings your doctor got are very similar to what a lot of POTS patients would get.

Morgan - thank you for your detailed explanation.

I have a really good book on heart rhythms and ECGs so I will use it to try to explain some of the technical terms used in the report.

Sinus rhythm = the heart's normal rhythm (pattern of electrical activity that tells the heart to contract in the correct order).

Sinus arrhythmia = still a normal rhythm but the beats get faster then slower then faster again. Very common and you can often feel it in your pulse or in your chest if you deliberately take extra deep breaths for a moment or two. Most young people get this, it is a normal variation and nothing to worry about.

premature supraventricular ectopic beat

premature = early

ectopic = not starting in the normal place (beats should start in the sinus node, this one didn't)

supraventricular = above the ventricles, this beat came from somewhere in the top half of the heart, usually the atrium.

these extra beats are very common (almost everyone has them most days), some people can't feel them, others as Morgan said feel the heavy thud of the next beat. They are often called PAC (premature atrial contractions). Nothing to worry about but can make some people feel horrible, sensation of a "skipped beat".

premature ventricular ectopic beats = PVCs - these are early beats like PACs except they start in the ventricles (the bottom of the heart), this is not an effective beat for pumping blood but a single one on its own is not a problem. The are less common than PACs but everyone is allowed to have the odd one. Runs of 2 next to each other are called couplets, 3 together are a triplet, more than a few beats next to each other and going fast is called Ventricular Tachycardia (VT). VT is not a good thing to have, but several members here have it.

Angela you are right that tachycardia does not mean the same exactly as arrhythmia.

Tachycardia = fast heart rate (above 100/min)

Bradycardia = slow heart rate (below 60/min)

Arrhythmia = abnormal heart rhythm (arrhythmias can be fast when they are called tachy-arrhythmia, or they can be slow brady-arrhythmia, or even at a normal speed, but they always have abnormal electrical patterns that can be seen on an ECG (EKG).

Essentially your report shows that your heart is often too fast but in a normal rhythm (sinus tachycardia), when you reported your symptoms your heart was beating fast. There were no worrying findings and the recording suggests that if you have POTS you may need your medications altering to make you feel better.

Quick note about ablations - Everyone is different and must talk to an EP (electrophysiology) consultant who is experienced in patients with POTS. I think the general feeling for POTS is that if you have abnormal electrical connections that cause troublesome arrhythmias then ablation may help. There was a study published a few years ago looking at ablating part of the sinus node to try to get rid of the POTS sinus tachycardia - this showed that more patients felt worse after the procedure than the number that felt better. There was nothing on your holter to suggest that you need an ablation.

I hope all of that makes sense!

Flop