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Holter test,nuclear stress test,palpitations,prolonged OT,heart pains

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Internal Medicine Specialist
Practicing since : 2007
Answered : 362 Questions
I am 71, 5'4", 200#. My holter test showed that I had 97,562 total beats, 58 BPM to 130 BPM. I had 23,676 (24.3%) VE beats; 16 couplets; 6,665/17 Single/Interp PVCs; 563/0 Single/Late VEs and 0000/903 beats bi/trigeminy. 4 SVE beats and 4 PACs. QT Min 250 msec; 659 max; QTc Min 319 msec & XXXXXXX 731; ASDNN 49.5 MSEC; SDANN 72.7; SDNN 100.1 1msec; RMSSD 34.8 MSEC I had a nuclear stress test and will get results Wednesday. What does this all mean in regards to possibility os sudden heart attack & What should I be asking my cardiologist?
I have a 20 page report if you want me to send ot via email.
Posted Sat, 5 May 2012 in Heart Rate and Rhythm Disorders
Answered by Dr. Kiran Kumar 6 hours later

You have had symptoms of blackouts and amnesia with palpitations.
Your holter is having multiple findings which include multiple VPCs and prolonged OT.

Mulitple VPCs if they occur in succession or together, can precipitate serious cardiac arrhythmias.

Please send your Holter report to me.
I will go through it and give you a precise advice.

You can mail me on YYYY@YYYY with Subject Attn: Dr Kiran Kumar.

Will await your response.
Dr Kiran
Above answer was peer-reviewed by
Follow-up: Holter test,nuclear stress test,palpitations,prolonged OT,heart pains 3 hours later
I have an appointment with my cardiologist on Wednesday morning and would like to know what questions to ask him. I'm sending a copy of my holter report in another email. Thanks.

I had heart pains for 1-1/2 hours two times today, which I have never had. They were aq "3-4", but for a lengthy time, I thought.
Answered by Dr. Kiran Kumar 12 hours later

Thanks for following up with me.

First let me apologise of the delay in answering to you.

I have gone through your Holter Report. My opinion is as follows

The two major concerns are
1. QTc if > 450 ms for 84 % of beats
2. There are numerous Ventricular Premature Beats (VPBs) (24 %) with majority being Bigeminy.

Normal QTc is < 440 ms in males and < 460 ms in females.
Your average QTc is 498 ms which is prolonged. Such patients are prone for Ventricular arrhythmias, especially Polymorphic Ventricular Tachycardia (Torsades depointes)

VPBs are common even in healthy people. However, you have multiple VPBs and they are occurring in succession. This could also be related to your QTc prolongation. Medications might be required to suppress the VPBs and o prevent development of ventricular arrhythmias.

Since the record need to be correlated with clinical findings, you may discuss about my findings with your primary care doctor.

Hope this answers your query. Please get back if you need any further information.

Take care

Dr Kiran
Above answer was peer-reviewed by
Follow-up: Holter test,nuclear stress test,palpitations,prolonged OT,heart pains 5 hours later
My question was "What should I ask my cardiologist when I see him?I do not know what you mean by QTc. Would you please explain this?

Thank you for your response. I will check this out with the cardiologist.
Answered by Dr. Kiran Kumar 1 hour later

There are multiple questions you should ask your cardiologist.
1. What are the probable causes of multiple VPBs ?
2. What is the risk that I can develop a serious cardiac arrhythmias ?
3. Do I need medicine to suppress thee ectopics ?
4. Whats the role of a pacemaker in such patients ?
5. Are my symptoms related these holter findings ?
6. When I did not have any sustained/non-sustained ventricular tachycardias, why do I develop these heart pains ?
7. Will a Treatd-Mill Test be helpful ?
8. What should I do for my QTc prolongation ?
9. Is there any need for angiogram ?
10. My holter reports that n symptoms were recorded. Does this mean that I need to repeat the Holter such that its on when I develop my usual symptoms ?

QTc is a measurement where we measure the distance between to waver of the each heart beat. If its prolonged, it put the patient at increased risk for ventricular arrhythmias.

Hope this answers your query.

Take care

Dr Kiran
Above answer was peer-reviewed by
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