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What do Holter monitor test results indicate?

Answered by
Dr. Ilir Sharka


Practicing since :2001

Answered : 7005 Questions

Posted on Thu, 22 Sep 2016 in Hypertension and Heart Disease
Question: I received my Holter Monitor results today and they are as follows:
Patient had a min HR of 29 bpm, XXXXXXX HR of 180 bpm, and an avg HR of 102 bpm. Predominant underlying rhythm was Sinus Rhythm. First degree AV Block was present. 2 episode (s) of AV Block (2nd?) occurred, lasting a total of 17 secs. 1 run of Superventricular Tachycardia occurred lasting 4 beats with a XXXXXXX rate of 150 bpm (avg 135 bpm). 2:1 Second Degree AV Block was present. Isolated SVEs were rare (<1.0%) and no SVE Couplets or SVE Triplets were present. No Isolated VEs, VE Couplets, or VE Triplets were present. 0 patient triggered events. 0 Diary entries
What would be your next step?
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
I would explain:

Detailed Answer:
Hello again, dear XXXXX!

I carefully reviewed your Holter monitoring results and would explain that the most important abnormalities found in your heart rhythm monitoring are the repeated episodes of atrio-ventricular conductance disturbances: more clearly the second degree AV block and 2:1 AV block.

The presence of the above types of AV block is a strong indication for pacemaker implantation (which is a device that sends additional electrical impulses to the heart, correcting that way the conductance abnormality and the subsequent sufficient impulses arriving to the ventricles).

But, before proceeding definitely to pacemaker implantation, it is important to explore reversible causes of AV block, such as an infectious disease (Lyme disease, etc.), certain systemic, inflammatory and infiltrative diseases (like sarcoidosis, hemochromatosis, myxedema, Reiter syndrome, ankylosing spondylitis, etc.).

That's why it is important to perform several medical tests

- cardiac ultrasound,
- thyroid hormone levels,
- complete blood count,
- PCR and other inflammatory tests,
- fractional blood protein levels, etc.

If a secondary reversible cause of AV block is detected, then treatment of the underlying disorder may probably obviate the need for pacemaker implantation.

You need to discuss with your attending cardiologist on the above mentioned issues.

Hope you will find this answer helpful.

In case of any further uncertainties feel free to ask me again.

Kind regards,

Dr. Iliri

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

The User accepted the expert's answer

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