What Does The Following Holter Monitor Test Results Indicate?

Posted on Fri, 23 Dec 2016

Fri, 23 Dec 2016 Answered on

Thu, 12 Jan 2017 Last reviewed on

Question : Hi, I am 29 yrs old male. I do physical activity often ( gym, work ) .I had really bad panick attacks ( started 1,5 years ago) , anxiety, social anxiety, fast hearth beating...etc. I felt really bad especially in the mornings. Now I am quite alright , the panick attacks are disappeared. I am hypersensitive of my body and probably hypochondriac as well. Couple of months ago I started experienceing skipping, irregular heart beats, usually in the morning or when I am relaxing or suddenly anytime. I feel a little bit dizzy this time, no chest pain, no faint, sometimes I can feel it more, sometimes just a bit. It is not regulary, I have days without it , and sometimes I have few times a day. When I have it I become really anxious. They did ECG twice & blood tests ( they were fine ) but these tests were before I started to experience these "skipping beats" . Now they've put me on 24 hours ECG monitor. My heart rates are 37 to 121beats per minute . Sinus tachycardia and sinus bradycardia noted. 2 isolated ventricular ectopics and 8 isolated supra ventricular ectopics. No significant pauses, no patient events recorded. No couplets , no total runs. I didn't feel this "skipping heartbeat" feeling when I had the Holter-monitor on me, now they referred me to do more tests. They said nothing to worry about, but they will do more tests, might be just calm me down a bit. Hopefully my results are okay. I really worry about it. Please let me know if You have any idea what cause this . Thank You.

Answered by Dr. Ilir Sharka (43 minutes later)

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I carefully passed through your question and would explain that your Holter monitor results seem to be within the normal ages.

You should know that during sleep, it is normal to have sinus bradycardia such as 37 bpm.

From the other hand during physical exertion or anxiety it is normal to have sinus tachycardia. For your age, the maximal heart rate would be up to 191bpm (220-age bpm). So 121 is not a very high heart rate.

From the other hand some skipping heart beats (including ventricular and supraventricular ectopic heart beats) are quite normal during physical exertion or anxiety.

So, there is nothing to worry about!

Anxiety could be the cause of your skipping heart beats. But this can happen in all healthy individuals.

So, to conclude, I don't think that your symptoms are related to any cardiac disorders.

But, I would recommend performing some other tests to exclude some metabolic disorders which can lead to skipping heart beats:

- complete blood count for anemia
- thyroid hormone levels for possibly thyroid dysfunction
- blood electrolytes for possible imbalance.

Hope you will find this answer helpful!

Feel free to ask me again whenever you need!

Kind regards,

Dr. Iliri

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar