I've just gained online access to my medical records and finally got to see the results of a 24 hour ECG monitor done in July 2022 (shown below). I haven't had a NHS cardiologist or electrophysiologist put this into laymans terms for me so was wondering if you good folks think it worthwhile paying for a private consultant to do that as I have no idea what it means and don't want to scare myself with doctor Google. Anyone else been in the same situation and took their report to a private consultant?
The 1 minute max heart rate of 152bpm was when I was on the exercise bike. The minimum 1 minute HR and the bradycardic episode where in the early hours when sleeping.
Resting ECG - Sinus rhythm at 92bpm, normal PR, QRS and axis.
Recording shows - Sinus rhythm throughout with mean heart rate of 74bpm.
1 bradycardic episode noted at 43bpm at 05:38 hours.
Minimum 1 minute heart rate 50bpm at 05:42 hours
Maximum 1 minute HR 152bpm at 15:33 hours.
214 polymorphic ventricular ectopics seen in isolation.
4987 supraventricular ectopics seen including couplets, triplets and SVE runs with the longest being 5 beats.
Event button not activated. No symptoms reported.
No further follow up is required at this time.
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1290Duke
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Correct Bob, I wasn't aware of anything noticeable so never pressed the button. It's just the high number of ectopics of different types that has got me flapping as I've no idea what they are and as I said I don't want to go to google as I'll just end up down a scary rabbit hole.
Ectopic= out of place. Ectopic beats are normal for everybody and generally benign. Stop worrying. What happens is that either the atrium or ventricle contracts before its partner is ready for it so if the ventricle contracts first the atrium has not pased any blood down to it so there is a slight pause in blood being pumped round. If the atrium contracts first the ventricle gets a double dose and then next time runs empty.
Really nothing to worry about everyb ody in the wprld gets them though maybe not 4k per day. May of us here have had them in the 10s of thousand. per dat.
Those ectopics can feel unpleasant but are usually nothing to worry about.
The ventricular ones (PVC's) are single and come from the lower chambers of the heart - normal occurrence.
The supraventricular are atrial ectopics (PAC's) from the upper chambers of the heart and are occurring in two's and three's with runs of SVE's (supraventricular ectopics) up to 5 beats in length. This is mighty uncomfortable but most of us have had them in some form or another at some time.
You had a low heart rate in the early hours and high when you were exercising. The important line is the last one - ie you're OK.
Duke, this exercise from York cardiologist Dr Sanjay Gupta may be of interest. I have repeatedly used his breathing technique to reduce and stop ectopics.
Dear Finvola, you seem to be very knowledgable on this. So having 4987 supraventricular ectopics in 24 hours is considered ok? My last ECG 5 day monitor a few years ago had 84 PVCs in 5 days and I was worried.
It's a lot to cope with I agree, especially if they are constant. The worst I had lasted for hours only but were like those described, every 2nd, 3rd and random beats. Some of us have a larger burden of ectopics, some less. I read somewhere that in some people with AF, ectopics are caused by an 'irritated' vagus nerve. Dr Gupta's breathing excercise calms the vagus nerve and - in my case - stops the horrible things.
The OP's report showed that no follow up was considered necessary, so the opinion was that the ECG was 'normal'.
How many PVCs a day is bad?According to a 2017 report, having more than 10,000 and up to 20,000 PVCs a day can decrease your heart's function. Doctors refer to this as PVC-induced cardiomyopathy. It's reversible in most patients if the PVCs are treated.
Hi, from what I have been reading it seems to be quite normal and harmless if you don't have an underlying heart condition and no one knows how to treat it really. It can come from anything, from stress, caffeine, even your posture when you're sitting. Some cyclists I read only get PVCs when they cycle but don't get it when they stop and rest. It's quite a mystery. I think like anything in life, eat healthy & in moderation, stay positive and don't let fear take over and just stay relaxed and all will be well.
I've heard of patients with a massive PVC load having ablation for them but don't know how successful it is as they can come from various foci. I think more than 15,000 per day is considered a lot - to me it sounds extremely massive!
Your resting heart rate, at 92bpm, seems high and is a question I would ask my GP, even though it would not be classed as tachycardia (>100bpm). I estimate total number of ectopic beats to be about 5% which is not considered important (i.e. called "benign"; I think above >10% is felt to be excessive and to begin to offer some risk of weakening the heart). Last night, for example, I measured my ECG for an hour and had a 10% ectopic load, which was hard to ignore, mostly PVCs, though. The reason we feel an ectopic beat, out of interest, is because it causes a delayed next beat which, arriving after a pause, causes the valve to close with more force, giving the feeling of a mild "thud". It is the valve closing that gives us the sensation of our pulse, not the ventricles contracting themselves.
Most of your ectopic beats occurred in the atrium, too, as PACs (premature atrial contractions). Those in the ventricles (PVCs) were "polymorphic", thus arising from several places in the lower heart.
Your GP would likely be well placed to give you advice on this, I'd say, well, as mine is. He or she will tell you if they have had this kind of training and experience. I don't know, but I suspect a cardiologist might need other evidence such as an echocardiogram to be able to say more.
To get a layout of your heart an ECHO should be done.
1 yrs 3 mths after stroke I asked for a Heart Specialist.
Before attending her I had an Echo and ECG. And 24 he
heart monitor.
Your clinic Dr should tell you the results of your ECG and that monitoring.
Specialist worry when your H/R is uncontrolled and that is over 100B/R at rest.
Your night is in low 40s ..um they may not like that.
I got avges Day and Night. Then Day 186 H/R. Persistent and rapid.
Night avge 47 with 2 pauses 2 seconds with Metroprolol. (Hate it)
Changed to Bisoprolol. Monitored avge Day fell to 156.
Private Specialist said 120 plus at rest on Bisoprolol.
Changed to include 120mg Diltiazem a Calcium Channel Blocker AM which does not affect 47 avge rate at night.
Bisoprolol Beta Blocker 2.5mg PM. Still remain avge at night.
Controlled 112-123/70-77. With H/R Day 69-88 ... Great.
Echo sussed out an enlarged Left Ventricle.
BB works mainly on BP and Rhythm
CCB works on H/R Day
Last DHB Specialist said that I have a Soft Systolic Heart Murmur
I had the Sept 2019 stroke at 2am but went back to sleep with a 'sore head'.
Left Frontal Ischaemic Stroke (Blood Clot)
AF. Rapid and Persistent
4 days at hospital the Carotid Arteries were CLEAR but the shadow on thyroid was
Papillary Cancer so 4 months later the right lobe tumour (no lump) and surgeons casing the Scan saw a tiny bit in left thyroid lobe so removal and surgeon to make doubly sure took all 12 right lymph nodes out. (2 were affected)
I've just had my 3rd Yearly Thyroid neck scan ALL CLEAR.
It was the sneeky thyroid cancer which gave me AF which gave me stroke!
At least I know what caused AF.
Probably hyperthyroid level as I still had high TSH in my body after the thyroidectomy. I could have gone into toxic ...
Low risk I declined RAI Radio Active Iodine and being in Suppression which is normally how they treat all patients after thyroidectomy.
A year later USA Thyroid Centre stated that Low Risk patients need mot be given RAI or put into Suppression mode.
Take care. Read all about it.
So has the followup I should hope Special as you would have been referred....I was
to DHB Heart Specialist for a talk on Rhythm drugs, anti.co.agulant meds etc.
Your report reads very similarly to my 7-day monitor over Xmas. The difference is I and my consultant were pleased by it and you were alarmed! We're all different of course and I'm not belittling your anxiety, just hoping to give you perspective. There's no AF. The rest is of little to no consequence and you should accept it as normal for you and get on with your life.
It's the first 24hr monitor I've ever had and I would imagine it's a curveball for anyone hearing for the first time that they had 4000 abnormal beats. I'm still adjusting to this Mugsy.
I’ve worn monitors numerous times and always learning about results. Most of the time I’ve not gotten a detail print out but then I never asked. I’ve just worn a monitor twice in the last two months/ I had over 7000 abnormal beats. Things are still being sorted out for me with not much positive results. Not sure I need what I’m prescribed- that’s another story exclusive to me.
I’d relax and do the meditation and breathing exercises to calm your mind
I’m a bit late picking up on this post, but I note that you said the ECG monitoring was done in July and you are only being given access to the the results now! That leaves a huge gap for the heart to settle and improve and you could be anxious over nothing.
I bought a wearable 24hr monitor called a Wellue AI ECG in December. The first trace showed lots of PAC’s and PVC’s and I was feeling pretty wrotten at the time after over exerting myself. Now everything has settled and I’m not getting them any more and the knowledge that I can redo a 24hr monitor at any point gives me real peace of mind. It’s not approved by NICE but I didn’t buy it specifically to send data to my cardiologist. Mine cost just over £200 but I figure that’s a lot cheaper than going private every time I feel something needs looking at.
I don’t know if an Apple Watch gives the same reports and analysis as the Wellue.
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