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Forum Name: Arrhythmias

Question: Rare Supraventrical ectopy/occasional isolated ventrical ect


 kelly326 - Sat Jan 24, 2009 10:54 am

opy. My48 hr. holter monitor results state say rare supraventricular ectopy and isolated ventricular ectopy. Also states 1 or 2 episodes of tachycardia. No sinus pauses (whatever that means) Average heart rate is 78 beats per min with normal heart rate variability. No cause for palps. identified on the recording. Cardiologist says I don't have an arrhythmia. Is that true??? I have anxiety and have been feeling the flutters for 4-5 yrs now. Can someone please explain. I would of asked the cardi. these questions but I wasn't looking at the test when I was speaking to him. All he said was I was just having palpatations probably due to my anxiety.
 John Kenyon, CNA - Sun Jan 25, 2009 9:28 pm

User avatar Hi there -

I think I can clear up this mystery for you. It's funny (well, maybe not funny, but interesting) how some medical people look at things without the patient's viewpoint figured in.

Your Holter monitor report, while very good, actually, also most certainly does explain your palpitations. It states very clearly there were a few premature atrial contractions (PACs) and some occasional, isolated premature ventricular beats as well. No sinus pauses (all the better), and a generally very normal and unremarkable set of findings, except -- you feel the occasional PACs and PVCs, and some of us perceive these as "fluttering" or something else that feels like more than just an isolated event. No one has been able to account for this entirely, although in some cases it can be due to a random pairing of premature beats,which just didn't happen during your particular monitored period.

Neither has anyone as yet advanced a convincing theory as to why some of us feel every premature beat (or even other activity that doesn't even produce ectopy), while others never feel any of it, even those whose every-other beat is a PVC!

The good news is that this is a very good, very normal, healthy result, but the problem is in the perception, and anxious people are more tuned in to what's going on with their bodies, especially their hearts (I personally am perplexed by the fact that some people are unaware of these things -- I feel every one). What's important is that just about everyone has some of this, some have more than others, some feel them more than others, but in no case are PVCs and isolated PACs of any medical significance whatsoever. This, unfortunately, doesn't mean just telling you that will prevent you from reacting reflexively when you feel one (or a series of them, which still doesn't mean anything as a rule). While it may help, there's no guarantee that knowing this is normal will make you more able to ignore them (or forget them more quickly). You suffer from something much more troublesome than premature beats: you suffer from anxiety.

Anxiety is a very real and often disabling problem. The fact that it can precipitate more premature beats than one might otherwise normally feel (and there's no rule there -- again, some people have thousands of them per day while others have them only rarely) just complicates the issue. It's not your fault! I do believe it's a doctor's responsibility to reassure the patient by explaining what's there and why it's not significant and that's what I, no doctor, am trying to do here. Working on the anxiety problem will, if successful, minimize the seeming importance you perceive in the premature beats. Trust me, one can change the other, and perception really is everything.

I hope very much this is helpful to you. Please follow up with us here as needed. Best of luck to you.
 kelly326 - Mon Jan 26, 2009 9:01 am

Thanks SO much for taking the time to write to me. I am hugging you right now!! :o) I know alot of it has to do with my anxiety and I am trying to work on that without meds. I am just having a fear of getting it pumping fast during workout and if it will someday get worse and more serious. Thanks again.
 John Kenyon, CNA - Mon Jan 26, 2009 12:01 pm

User avatar You're very welcome, and thank you for the hug. Those are always welcome. :)

You're to be commended for trying to work through the anxiety issues without medication. If you succeed, all the better. I hope you'll be able to recognize if there comes a time when it would be helpful to accept temporary medical management of the symptoms, but it's very admirable (and ideal, of course) to be able to do without meds. I wish you every success. The fact that you're so aware of what's going on suggests you're more likely to pull this off on your own. I certainly hope so.

There's nothing in your Holter report to suggest any reason for concern about getting your rate too high or setting off a rapid tachyarrhythmia. Should anything funny turn up that leaves you wondering, we're here to help sort it out, but I doubt you'll have any problems like that.

My best to you.

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