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Hello,

I am a 63 year old white male whose Father had many heart related issues. I stay fairly active despite my age but have been experiencing more frequent periods of low pulse rate with usually "pausing" every 10 beats or so. Accompanied with those periods my breathing is more labored. Yesterday I had a nuclear stress test and was told I had no blockages. However prior to the stress test I wore a heart monitor for one month. I have attached the results from the monitoring below:

FINDINGS: 30 DAY EM (24 days) 12/18/2025-1/17/2026 AVG HR 61, MIN HR 36, MAX HR 143 NSR 61.79% SBrady 33.40% SVE 4.80% VE 0.01% Pause/Block < 0.01% 7 pt triggered events-no symptoms associated with Bradycardia NO AFib Minimal Ventricular ectopy SVT longest 12 beat sequence; fastest @213bpm 9 beat sequence both in the afternoon No new meds and no additional meds.

I understand that 33.4% of the time my heart was beating at less than 60 bpm. But I am not extremely clear on the SVE for 4.8% of the time. Is this the actual "pausing" I'm experiencing? If so what causes it and what if anything can be done to minimize / correct to the problem, and do these results WARRANT anything being done. I do exercise, (treadmill), pretty frequently so the max HR of 143 is understandable. Also are the 2 episodes of SVT of concern? I do not see my cardiologist until late May.

I appreciate any insight.

Sincerely,
Greg

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Replies to "Hello, I am a 63 year old white male whose Father had many heart related issues...."

@pamandgreg First, I am NOT an expert in this...no training. None. However, I believe that SVE stands for 'supraventricular ectopy', meaning.....probably.....PACs, or premature atrial complexes. You get a pause, then a catch-up beat that is especially powerful and feels like a surge or a thump in the chest.

Those results do say no bradycardia, even with that one low reading. It depends on what you reported was going on at the time. When they read the data, they also try to match any recorded events of note. If you were asleep, or seated, slouched, relaxed, hadn't eaten in three hours or had a coffee or a soda with caffeine....a reading of 36 for a fit heart is not out of the ordinary. My HR would often fall to 38 after bounding up two flights of stairs to a washroom. Climb, sit on the john, waited 30 seconds or more, then took my pulse. 38. I call that a great recovery, not bradycardia. And when physicians took my pulse for some reason, they'd raise an eyebrow and ask, 'Are you a runner?'

Your 'burden' of SVE, if it is PACs, is not dangerous. Everyone has them, some more than others, and for some, who find them rising in both number and frequency, it often means a slow slide toward atrial fibrillation. I hasten to add that the burden can rise to a point where it becomes consequential if not treated, and this is where an electrophysiologist would want to take a look at your heart. Mostly, it is what you tell that person...how you sense the events, how they make you feel, and how much you'd really prefer to be rid of them, or at least to have their number strictly controlled. IOW, your symptoms matter....a lot. To most patients, THAT....is the real burden...not how many ectopic beats you get in a 24 hr period, which is how they decide when your burden is getting onerous.
https://biologyinsights.com/what-pac-burden-percentage-means-for-your-heart-health/
https://www.jstage.jst.go.jp/article/circj/85/8/85_CJ-20-1277/_pdf/-char/en