I’ve received the result of my 24 hour 12-lead Holter, but not the interpretation-I will not see the consultant for about 7 weeks. The summary reads: “Indication: to quantify VE morphology and burden. Sinus rhythm with occasional supraventricular ectopics. One run of non-sustained ventricular tachycardia (15 beats at 118bpm). Reduced heart rate not specified ventricular or atrial (but mostly ventricular)profile with rare non-conducted SVEs. HR 38-73. Average: 53bpm. 227 polymorphic ventricular ectopics, including a run of non-sustained ventricular tachycardia (15 beats at 118bpm). 2851 Supraventricular ectopics including including five couplets one triplet and salvo.”
Much of this sounds reasonable but I was rather concerned about the tachycardia. After some googling I came across the following “Non-sustained ventricular tachycardia (NSVT). VT can be a potentially dangerous rhythm, especially in the setting of coronary artery disease (I had a bypass 20 months ago). Even though it’s non-sustained, VT indicates that the ventricles are electrically unstable at times. If this becomes sustained, it can lead to hemodynamic compromise or even sudden cardiac arrest. Non-sustained VT often requires further evaluation, especially given your heart disease history.
Does anyone have this condition or know anything about it? Have I got hold of the wrong end of the stick?
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Samazeuilh2
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You need professional opinion here. VT very much depends on you and your heart. Non-sustained VT is likely more common than anyone knows. You had a very short run. I would guess the cardiologist will pooh-pooh it and say not to worry!
Dr Google is a very bad source of information about VT, I fe. Also, you might have a bundle block, as I have, and that can create an ECG that looks like VT but isn't. Again, your doctor will know.
I do have BBB. You are also right that NSVT is not easy to evaluate. I’ll just have to be patient and wait for the appointment- I hope you are right and it turns out not to be of concern.
I very much doubt that it would have been VT in that case. I went rushing to see my consultant when my ECG showed just this, too. He explained that it was an artefact of the LBBB and was all atrial and not ventricular.
He explained that LBBB prevents the ECG working properly such that only an expert eye can interpret it. The initial results of your ECG will have been done by computer AI which us easily fooled.
Hi Samazeuilh, I’ve only just belatedly come across this post of yours when doing a search on ‘NSVT’. How are you doing now? I see from the timings that you may well have seen the consultant now and got an answer about that possible NSVT? I’d be v interested to hear how you got on, and what he advised. Here’s hoping it was good news for you!
I’ve recently seen my EP privately to discuss increasing episodes of NSVT caught on my Wellue. I was hoping he’d say they weren’t in fact NSVT, but he confirmed that they are. (And this was doubly confirmed when I had a Holter monitor on.) However, he didn’t seem at all worried and is happy to monitor. Which is good!
I have an appointment at Barts next Wednesday when I will discuss the NSVT. I spoke to a cardiologist at my local hospital a month ago who said, rather unhelpfully, that it “might, or might not be significant- at any rate you are on the right medication.” He basically deals with the follow-up to the bypass I had two years ago and doesn’t want to get involved with AF issues. I’ll be asking a lot of questions about it on Wednesday and will let you know what information I manage to elicit.
I’m glad you’ve got your Bart’s appt next week. Understandable the cardiologist doesn’t want to interfere, but even so, that’s not the most helpful of comments!
I was taken aback by how unbothered my EP was about traces of frequent NSVTs even when confirmed to be genuine VT -and of course that’s only when monitoring, so the overall incidence can’t be known. But I’m sure the approach is different for every person depending on their history and medication options, and (dare I say it) depending on the individual consultant. Be very good to hear what yours says to all your questions, please do let us know. I really hope it’s reassuring news. Jx
I’ve been told that if the heart’s ejection fraction is below 50% (mine is 50-55%- rather too close for comfort) they are considered to be more dangerous. Also, conditions like cardiomyopathy, coronary artery disease, or a history of a heart attack may indicate that the NSVTs can lead to an increased risk of developing more serious arrhythmias, like sustained ventricular tachycardia or ventricular fibrillation, which can lead to sudden cardiac arrest. All in all not a nice prospect. One option- to be avoided if possible- is an implanted defibrillator. In my case, I had one episode over a 24 hour period monitored with a Holter. I don’t even know when it was- possibly when asleep. I have no idea if it was an isolated episode. I will let you know what I find out on Wednesday.
Ah yes that all makes sense. I guess they're always trying to work out the likelihood of it turning to Vt or VF, and I agree the implanted defibrillator is something we'd hope never to need. (Though I know someone who had one implanted when he was 21, and it's saved his life a number of times, even when he was in a accident that caused his heart to stop, so he's a fan!)
Good luck for Wed, and hoping you have encouraging news.
I had my St Bart’s appointment last Wednesday and said I would pass on any information about the NSVT. I was told that that as my heart ejection fraction was acceptable (if not brilliant at 50-55%), I didn’t notice the (single) episode and it wasn’t particularly fast (115 isn’t fast according to him- it sometimes goes to 200), he wasn’t particularly concerned. He said that even normal hearts sometimes have short episodes. For the moment it’s ok to “watchfully wait”. He will order a longer Holter test if it’s necessary.
So it seems the seriousness depends on the interplay of many different factors: frequency of episodes, ejection fraction, whether the episodes are symptomatic, how fast the episodes are and so on. It sounds as if your EP considers your ejection fraction and the other factors mentioned above to be in an acceptable area too. Certainly, if you saw him privately that’s even more reassuring as private providers are not shy about advocating further testing if there is even a chance they are needed. That said, you could check over the details of your episodes to make sure nothing has been missed.
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Help with the result
Can a GP get a consultant to bring an appointment forward for a patient if the symptoms warrant it? (& shd EP deal with non-sustained VT?)
So now I'm a bit scared.
