Summary of symptoms: Appeared out of the blue about four weeks ago. Had EKG - normal, and 24 hr. holter, results listed below. Dr. called yesterday and said that Holter results are normal, but I have a fast heat rate. My symptoms are fast pulse, sob, dizziness, flutters, slight stabbing pains (all of this on the left side).

Anyway, I guess the Holter results are good news, but I can't understand the report. Can someone please explain each line item. Also, if the report is normal, why do I still have the symptoms? Will they go away on their own? How does a Dr. say all is normal, when these symptoms appear out of the blue? So many questions, but maybe I'm stressing over nothing - should I let it go or pursue!

Report Summary:
Patient was in sinus rhythm, the average heart rate, excluding ectopy, was 83 bpm with a minimum of 54 bpm at 17:21 day 1 and a maximum of 130 bpm at 02:07 day 2 (thought I was asleep here!). Hear beats, including ectopy, totaled 120515 beats, there were no ventricular ectopics found. Supra Ventricular Ectopics totaled 16, averaging 1 per hour with 16 single and 0 paired beats.

INTERPRETATION:
1. Rhythm is sinus.
2. PR and QRS are within normal limits
3. (16) single SVE's noted
4. Symptoms of fluttering, sob, and cp corresponded to normal sinus rhymth with heart rate of 90-110 bpm.

Thanks so much for your time. :wave:

luvthenet,

The sinus node (SinoAtrial node) is the pacemaker of the heart, firing at a regular rate of 60-100 times per minute. Each beat is conducted normally through to the ventricles, thus beating equally together. The R-R intervals are constant, atrial and ventricular rates are equal, the P wave is uniform and in front of every QRS complex, the PR interval measurements fall within the norm and constant across the strip, and the QRS complex measure is within the norm and constant across the strip. In a normal EKG measurement the norm for PRI .12 -.20 seconds and QRS of < .12 seconds. All of that gives the parameters for a normal heartbeat, the technical definition in EKG jargon. If you look at an EKG strip, the complex ... the first hump is the P, the straight line is the PR segment and together all of those are called the PRI (see the normal time range above). Then the small dip, the first negative deflection, is the Q. The long straight-up line, upright deflection, is the R, the line going back-down, the second negative deflection, is the S, and together they are called the QRS (with # range above). Finally, the last hump after the QRS complex is the T wave. All those things are called waves...P wave, S Wave...and so on. Am I putting you to sleep...zzz :nono:

An Ectopic beat is an electrical stimulation of cardiac contraction, or the electricity that makes the heart muscle move, beat, but it is beginning at some point other than the SinoAtrial node, the normal spot where the heart fires off a normal rhythm. Simpler language, it's originating from a focus other than the primary pacemaker. A holter has a limited number of leads, those nasty, sticky do-dads you wore. With a 12-lead EKG they can distinguish the type of Ectopic in terms of being a PVC, premature ventricular contraction (of the ventricle), or a PAC, premature atrial contraction (of the atria), and so forth, but you must have one to register it while they run the EKG. Don't worry, everyone gets an occasional premature beat and yours averaged less than one per hour within 24hrs. SupraVentricular, when a beat is supra it is generally over 110-120 bpm and ventricular means that range originates below the atrium. So you were at 130 and that can come from lots of things other than medical including stress, food, sugar and all those bad goodies that make our hearts go pitter-patter. :confused: -Hey, did you say three kids? Ya ...Any way, a single ectopic is one but there can be two, a bigeminy, or three, a trigeminy, and so forth. Single is very good and normal. Fluttering is rhythmic, rapid beating of the heart muscle. Now, did you write "fluttering" in your journal, or did they deliver the word? I'm not sure but if sob (is shortness of breath? -instead of what is usually stands for :eek: ) and cp (is chest pain?), those abbreviations, then they are corresponding to your journal compared to the actual holter strip. If that is the case, while you notetated these issues your heart was beating at a normal rate firing electricity from the right spot. In other words, your ticker was A-OK! :bouncing: So, if you're feeling things but they are not found on the strip, paralleled, then what you're feeling is a sense coming from something other than your heart. The summary, you had a sinus rhythm which is normal, and your beats are typically averaging 83bpm, with 54 bpm at the slowest (and that resting rate is normal...it can go as low as 40 via AV Junction) and one event at 130bmp which is only 9 to 20 bpm faster than the averaged norm. It's not unusual to have a rapid beat at sleep because there are possible factors that relate to dreaming, sleep patterns, or other things that can be done while one "sleeps." :nono: :eek: Although your ectopics are undefined, it sounds like the firing spot is not from the ventricles and within the ventricles; instead, they are likely working within the routing system of pathways normal to the electrical system. Granted, there can sometimes be extra branches, but that cannot be determined with a holter, so set that aside until you get more precise tests. It's a good report that can stand alone or have just a little bit more definition. If you feel an instinct that you should know more, then contact the doctor and ask if there are other tests to get a better definition to the ectopics. Feeling something that is not correlating to the holter strip should not bar that. Obviously you are sensing something that was cardiac because the ectopics, faster rate proved that. So, if the doctor tries to put you off...state is this way, that there is evidence and you want it defined, thank you very much...now do it...please :p . All you want to know if it is truly normal or an actual issue, but some doc's get too technical and forget our rational feelings. Remember that "emotional" factor, and don't let yourself be prohibited from investigating your health. The doc may say you felt things that did not correspond to the strip, and play that mode, but be gently assertive. A lot of people do not feel ectopic beats and slightly faster rates, but that is no reason to ignore the origin. State that to the doc and watch the squirm. As well, should they go away and then return sometime in the future, and you never got any further tests beyond the Holter, then you'll likely be able to easily get more pinpointed tests. Any way, I wish you the best. Double check everything because I may be wrong, hey-it's an opinion, and smile...you have a "good" heart! :D

Thank you so much Dreambetter. WOW :eek: Seems like you know your stuff! I'm sure that your response is more complete than any one that I will receive from my PCP. In fact, I have to ask, are you in the medical field?

Based on your explanation of my report, sounds like I should let it go for awhile. I guess I just want someone to tell me how these types of symptoms can creep up one day when they've never happened before and now continue on a daily basis for weeks on end - alas, I know this question has no answer. I wonder if this a typical scenario that can disappear as quickly as it arrived, while remaining unexplained the entire time? :confused: Especially the SOB.

Happy friday!!!

luvthenet,

I was diagnosed with a heart condition in my late teens and always seemed to end-up in a lot of teaching hospitals and ERs. As a result, I realized how much it helped a patient to manage their condition by having knowledge of it, so I studied and never stopped. By my thirties I was quite fortunate and found myself at very well known teaching hospital and was treated by a visiting cardiologist from the Mayo clinic, -he thought I was a nurse or studying medicine. As well, from time to time my brother hung-out with me, he went to medical school, and together we sought out lots of learning situations there. The doctor eventually gave me scrubs and access to the medical school's library, a few lectures, classes, and let me sneak into fantastic things. I also volunteered for every imaginable cardiac test there was, I became obsessed. The doctor had made me aware of a new procedure that was being tested, RF Ablation, and guided me to its pioneering cardiologist and hospital. Eventually I was accepted as one of the guinea pigs and had the procedure done, 7 hours... :eek: When I had that procedure my "teaching" doc had already returned to the Mayo Clinic but he had asked me to call before the surgery was to be done. When I was in the OR for the ablation...guess who was there, yup...the Mayo doc at his own expense. :angel: That experience truly changed me and I vowed to get some sort of medical paperwork. Eventually I schooled and was credentialed as a CVT with 5 relating areas. :dizzy: Today I continue to study and have an occasional cardiac problem, but I decided not to work in the field of medicine because I don't like the way patients are treated. I'm too outspoken to watch what's going-on. Finding a doctor like the one from the Mayo is tough. I have assisted many friends and acquaintances as they go through the medical system, including hospice, and that's good enough for me. You really have to know about your condition, the options available, ask tons of question (whether you think they are dumb or not), and fight for your right to have the best possible medical treatment. Did you know that there are too many patients who die as a result of being given the wrong meds, the wrong surgery or catch infections while being treated in hospitals? You have to keep every sense open and aware of your medical treatment. And if you are not able to do that, have a plan and make sure you have an advocate there with you. :rolleyes: This person can be anyone who you'd trust your with life. My interpretation was my opinion, but you need to have an office follow-up with your cardiologist. Insist and book it, it's your right. As I had stated, with hope that nothing is wrong with you, double-check. Talk to you doctor about the symptoms you've described in your first post, especially the shortness of breath. Determine if there is any physical factor of any kind that might be causing it. Find-out if there any noninvasive tests that might truly rule out a physical issue, especially cardiac, and get a definition of the ectopics. Via phone the doc let you know that your heart is all right, you had a good EKG and Holter, just follow-through and get all of the answers from your Doctor face-to-face. I'll ask you this, if it were one of your children wouldn't you want to do everything to make sure things are all right? ...Be that same advocate for yourself. Know as much as you can about what your body is doing so that you can truly aim for the best for yourself. From a mental standpoint, if your symptoms are not being caused by the physical, just the knowledge of that can help you self-coach and possibly overcome problematic issues. I truly wish you the best and take the great care of yourself! :wave: