Help with potential severity of Holter Monitor results

Heart health and blood vessels
1

First off, I do know I need to see a cardiologist. However, I do not currently have one and I am relocating across country in 8 weeks, so getting into a cardiologist at this point is pretty impossible and will need to wait. Problem is, being a person who already suffers from a panic disorder, waiting 8-10 weeks could make my symptoms worse just from sheer worry. Hoping some of you can help shed some light on what is going on and the results of my 48 hour Holter Monitor I just received.

First some background. I am a 48YO female, overweight, only medical issue is high blood pressure for which I take 5mg of Amlodopine and 40 mg of Benicar. About 18 years ago I started having PVCs. At that time, I would have a few hundred in a day and they would come and go periodically throughout the year. I had a full cardiology work up and found nothing structurally wrong. I was told to avoid triggers like stress and caffeine when they flare up. This past November they came back with a VENGEANCE. They started up after 5 months of intense stress (working full time along side spending 40 hours a week renovating our home to put up for sale because my husband's job was relocating across country). This flare up was the worst I had ever had. I could experience 6-10 skips in a minute. More troubling was that I was also experiencing sudden bursts of racing heart. This lasted from November through December then calmed down for January-March. Then in March it started back up and has been getting worse so I called my doctor and requested a Holter Monitor. He refused to put me on one and sent me to the ER instead. Rather than the ER, I ended up at a walk in clinic where they did a bunch of blood work (everything PERFECT that was tested. Cholesterol 135, everything in optimum ranges; vitamin/mineral panel; thyroid panel, etc, all good). I just got the results back from the monitor and all my General Practitioner will tell me about it is I need to see a cardiologist. Can someone help with some feedback on my results?

Duration: 47:59

256305 QRS complexes

1655 Ventricular ectopics which represent <1% of total QRS complexes

618 Supraventrical ectopics which represent <1% of total QRS complexes

0 Paced QRS complexes which represent <1% of total QRS complexes

Ventriculars (V, F, E, I)

1573 Isolated

0 Bigeminal Cycles

35 Couplets

2 Runs

6 Beats in Runs

3 Beats Longest at 230 BPM at 16:43:16 10-MAY

3 Beats Fastest at 230 BPM at 16:43:16 10-MAY

Supraeventriculars (S,J,A)

402 Isolated

35 Couplets

24 Runs

146 Beats in Runs

16 Beats LONGEST at 131 BPM at 10:26:25 11-MAY

3 Beats FASTEST at 135 BPM at 14:42:02 12-MAY

Heart Rates

62 Min

91 Avg

144 Max at 20:13:00 10-MAY

Interpretation

1. Frequent isolated PVCs (1573), 35 couplets, and a short run of non-sustained ventricular tachycardia of 3 beats at 230/min

2. Short runs of atrial tachycardia, longest 16 beats at 131/min

3. Palpitations correlate with ventricular ectopy

4. No significant pauses or bradycardia

(personal side note)

Interestingly enough, the thing I was MOST excited that they would've caught was I had one of my events of racing heart, where my heart just skipped and then took of racing. Ironically, it happened at around 8 o'clock on the 10th and there is NOTHING mentioned about it on the report other than highest heart rate reported at 144max at around that time... confused about this one, as well.

Thanks everyone for any feedback you can offer my on this. I'm just trying to stay calm until I can see a cardiologist later this summer.

2

Hi Lori, I am not a medical person. But the only thing I see that really stands out is the supreventricle stuff and the non sustained ventricle tachycardia. I have had that and it can be dangerous in a weak heart. So, they probably want to do an echo on you to see if your heart is normal. If it is. You sound good to go. I would at least go have the echo. Then you can relax before your move. That is my advice. Good luck and I hope this helps!! All the best, try not to worry! Mabel

3

Hi lori, I don't know what to say, but I'm another with what is becoming a long history of very disturbing arrhythmias that the doctors just shrug off.  Sounds like what you describe.

My one useful contribution is that adding a beta blocker may help, at least a little.  And, getting *off* the amlodipine helped me as well.

I've worn Holters a few times, "event monitors", in-office EKGs, an echo or three.  I guess I should be glad nothing "serious" was found, and I'm still walking around without major events years later, but I sure do wish I could at least get a diagnosis and not a brush-off, and THEN maybe something more that would help.

4

Thank you! Yes, you are correct, an echo and a chemical stress test have been ordered. My GP's nurse worked a miracle and got me into a cardiologist. The tests won't be run for another 4wks, so hope to get the results before we move.

5

You hit the nail on the head. This is EXACTLY what they are doing. I got into a cardiologist by way of some magic my GP's nurse performed. I waited 2.5 hrs for him to come into the room and he spent a whopping 10 mins with me. Didn't care to hear any of my story or what I'm "experiencing". But he's supposedly the best in the area, so I guess all he goes by is what "the tests" say and not what the person says. He read the monitor report, declared I needed further testing, ordered an echo and a chemical stress test (not sure why the chemical...perhaps due to my racing issues, perhaps because I had a run of NSVT, he didn't take the time to say) and he took me off the amlodipine and put me on 50mg of Metoprolol instead and said that should help with my symptoms. And then said, if my tests come back all clear, I don't need to see a cardiologist for another year, didn't even schedule a follow up to discuss the results {{{{huh?}}}}