Holter Monitor Results

I did feel those weird sensations, including a distinct and awful, foreboding, pin-prickly sensation at the back of my neck, and this WAS while driving. Fortunately, it happened latterly, about a month prior to my first ablation (which failed on the sixth day and I had to be hospitalized and placed on amiodarone immediately). The culprit, I feel, was metoprolol. My dosage had increased, and I feel that, after the ablation, it was simply too much, and I was told by the ER nurse who came running into my room, only to find me chatting amicably with my wife, that my heart had stopped on their desk monitor (holding her two index fingers yay far apart in front of her) for that long. ?!?!?!?!?!

I'm happy to see you able to keep it all in perspective, and to be analytical about your experience. You're most certainly not a psych case, and it is good to see you relate that your experience at the hands of your expert care-givers has been salutary to date.

GPs are not qualified to determine many pathologies be they heart or anything else. They are a can be a starting point but not an end point. From the report it states "There were 20 patient events with symptoms of fatigue dizziness lightheadedness shortness of breath and palpitation". So it appears as if you complained of symptoms to your GP who then ordered the Holter? I am guessing here. I would insist on a referral to a EP for further evaluation esp. based on symptoms. Ectopic beats do not originate from the sinus node and have a different wave configuration on an ECG/holter monitor. What is too high is a question for an qualified EP to answer.

Here is my 14 day heart monitor results. I don't know how an average hr from 42 bpm to 226 bpm can be 66 bpm. Does that calculate result from time at 42 bpm vs time at 226 bpm?

Anyway that isn't my question. I have heart disease, and am missing my upper right lung lobe due to lung cancer (I was told that can be an additional stressor for my heart). I take Fluticasone propionate Salmeterol for asthma and COPD. I also take 25 mg losartan daily, although when my heart rate is in the mid to low 50s I am reluctant to take the losartan because I don't feel good with that low heart rate. I was diagnosed with SVTs 25 years ago. I now have some couplets and triplets.

here is my 2 week zio results:
Patient had a min HR of 42 bpm, max HR of 226 bpm, and avg HR of 66 bpm.
Predominant underlying rhythm was Sinus Rhythm. 70 Supraventricular Tachycardia
runs occurred, the run with the fastest interval lasting 4 beats with a max rate of
226 bpm, the longest lasting 17.4 secs with an avg rate of 114 bpm. Some episodes
of Supraventricular Tachycardia may be possible Atrial Tachycardia with variable
block. Supraventricular Tachycardia was detected within +/- 45 seconds of
symptomatic patient event(s). Isolated SVEs were rare (< 1.0%), SVE Couplets were
rare (< 1.0%), and SVE Triplets were rare (< 1.0%). Isolated VEs were rare (< 1.0%,
135), VE Couplets were rare (< 1.0%, 6), and VE Triplets were rare (< 1.0%, 1).

VE Beats
(No./hr)
11 9 5 8 13 4 4
< 0.1% < 0.1% < 0.1% < 0.1% < 0.1% < 0.1% < 0.1%

Not much of this make sense to me however when I see the results I wanted answers and was told it was fine, with no answers.

The low average HR that is close to the lowest value tells me that you don't spend much time at the highest value, or higher values than the average number given by the Holter. IOW, you are quite apparently paroxysmal, which is good news. You self-correct in a few minutes or an hour and you're back in NSR (Normal Sinus Rhythm) for all or most of the day. This means your left atrium is probably only slightly enlarged, and that, in turn, suggests that your mitral valve deterioration and fibrosis are minimal. Now is the time to consider an ablation unless you are well controlled by medication and stress reduction....and good sleep.

I don't see RVR mentioned, so that's a bonus (Rapid Ventricular Response). Also, atrial fibrillation and flutter don't appear in the data, apparently. So, it's just SVT, or supraventricular tachycardia. This means you're not apparently fibrillating with chaotic beats in the atrium. Instead, it's NSR, but too fast at times for no apparent reason or no associated demand.

I'm not a health expert, but you are wise to monitor your BP and HR to ensure the Losartan is not pushing you down into bradycardia (HR lower than 50 BPM). Consult your cardiologist or electrophysiologist about cutting down on the Losartan if it isn't keeping your rate low enough when you ARE in SVT. IOW, if it isn't really doing its job, and if your SVT incidence is low (properly called the 'burden'), then maybe just monitor and keep the medicine for days when you have more SVT and you know it. But do whatever the experts say, not what I say.