Irregular beats

After being unwell with arrhythmias for several weeks, I had an echocardiogram and a 7 day monitor. As it happened, these two tests were done during a period of feeling well which I have been this month up until recently. The echocardiogram result said: LV non-dilated with mild concentric hypertrophy (1.3cm), Systolic function normal at 65%, Left atrium borderline dilated, No other significant valve abnormalities,

7 day report had lots of stuff I don't understand but the summary was: No arrhythmia, Tachy, Brady,

SVT: 1 event HR range 115 to 124, longest 4 beats/1.5 secs, Super ventricular ectopics 175 isolated, couplet 33, run count/beats 1/4, Ventricular ectopics, isolated 5

Longest RR 1.3 seconds, Average HR56, AF none found, AV block, none found, VT none found

Artificial Paced Rhythm (close to 99.9 % of beats). Maximum heart rate (81 BPM), Minimum heart rate (52 BPM) and Longest RR interval (1.3 seconds) occurred during with Pacing. Ventricular ectopic beats were noted in Single beat forms. Supraventricular ectopic beats were noted in single, pair and run forms.

I have not had the above explained to me so if anyone can help with it, that would be wonderful. I am now unwell again with lots of palpitations and irregular beats which are leaving me very tired with chest aches. Whenever I check my BP and HR on my monitor, which I do several times a day, it is usually 55bpm which is CRT-D setting and in sinus rhythm. 
Tomorrow I am having a 48 hour monitor fitted to see if they can catch what is happening. Any comments on all of this, thank you.

1 Comments

I hope the following helps

by Gemita - 2024-04-30 03:24:23

Graham, I am sorry you have been struggling again with rhythm disturbances and with the frustrations of monitoring.  When we are “actively” looking for evidence, heart rhythm irregularities can be so elusive!  This would be my interpretation of your results if I had received them, but of course you will need to be guided by your doctors not by me.  

The echocardiogram appears to show a normal functioning heart with only mild disease of left atrium/left ventricle, so no “major” cause there for your rhythm disturbances.

Your 7-day report confirms you were not particularly symptomatic with “no arrhythmia or tachycardia/bradycardia”.  Slightly misleading because it clearly showed at least one short run of SVT (Supraventricular Tachycardia) and episodes of ectopic beats. 

SVT: 1 event, heart rate range 115 to 124 bpm, longest 4 beats/1.5 secs duration, so insignificant.  SVT = Supraventricular Tachycardia which affects the heart's upper chambers (supra ventricular means above the ventricles).

Super ventricular ectopics should read “Supra” ventricular ectopics = ectopic beats starting in the upper chambers of your heart, also known as premature atrial contractions.  You had 175 isolated beats recorded of Supra ventricular ectopics.  

Couplets = two supra ventricular ectopics occurring one after the other.  33 of these were recorded.

Frequent Supraventricular ectopics are sometimes a strong trigger for atrial fibrillation or flutter or other supraventricular tachyarrhythmias, like SVT, so they may need controlling.  Mine often lead to Atrial Fibrillation so I hate them too!

All your ectopic disturbances were mainly confirmed as being in the upper chambers of your heart (Supraventricular ectopics) on this occasion, with only some isolated single beat ventricular ectopics, 5 in number recorded during the period of monitoring.

The “heart rate” can be described as a true rate in beats per minute or as the RR interval in milliseconds. 

In summary, longest RR interval recorded was 1.3 seconds, Average heart rate was 56 bpm, no AF, heart block or Ventricular Tachycardia was seen.  Artificial Paced Rhythm (close to 99.9% of beats) was noted which means you are paced 100%. Ventricular ectopic beats were noted in single beat forms only, whereas Supraventricular ectopic beats were noted in single beats, pairs and run forms (see my definitions above).  This tells me that your atrial ectopics were more troublesome than ventricular ectopics for the period of monitoring. 

Although your monitoring report for the 7 day period did not show anything serious, I can see that your heart is electrically excited.  I am sure if they capture what is happening when you are really symptomatic, they will understand just how much you are affected by these disturbances.  Ectopic beats can certainly adversely affect pacemaker cycle timing (another subject for another time) and cardiac output, so I hope your additional 48 hour monitor gives your doctors a better picture of what is going on.  Just be aware that many of us suffer from frequent, symptomatic ectopic beats, so you are definitely not alone.  With so many of us looking for an effective answer, I am sure we will eventually find one

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