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    What do the following test reports indicate?

Posted on Mon, 24 Jul 2017 in Hypertension and Heart Disease
Question: 24hr ecg results by computer showed nothing but 2 paced beats, summary sheet by technician says no ectopic beats seen. Can I therefore assume the technician checked the 2 paced beats to see if they were in fact ectopic beats?
5 PAC's on treadmill test, is this significant? Thanks.
Answered by Dr. Ilir Sharka 23 minutes later
Brief Answer:
I would explain as follows:

Detailed Answer:

Welcome and thank you for asking on HCM!

Your 24 hours ECG monitoring seems to be within the normal ranges.

Yes, I assume that the technician has checked those paced beats.

Anyway some ectopic heart beats (PACs) are quite normal during physical activity or anxiety in every normal and healthy person.

So, it is quite normal to have 5 PACs on the treadmill test.

Hope to have been helpful!

I remain at your disposal for any other questions!

Wishing good health,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ilir Sharka 11 minutes later
And if he hadn't checked the 2 paced beats could they be anything else?
Answered by Dr. Ilir Sharka 17 minutes later
Brief Answer:
My answer as follows:

Detailed Answer:
Hello again!

Regarding your concern, I would explain that it does not matter if those ectopic heart beats were atrial (PACs) or ventricular (PVCs) extrasystoles, because such small number of ectopic heart beats is quite normal in every healthy person with a normal cardiac ultrasound.

It makes no difference if the technician checked or not those paced beats.

So just relax and don't worry about it!

Hope to have clarified some of your uncertainties!

Wishing all the best,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ilir Sharka 21 minutes later
Thanks that what I thought but I am assuming a technician would have checked hence why he put no ectopics seen as would they usually put that?

You say the 24hr was within normal limits would the one that showed 2 PAC's be normal as well.

Final think is my treadmill Test said st depression of 1.1. Is this too high, I understand that also increases with exercise.

Sorting my anxiety will hopefully stop me feeling the odd ectopic.

Great answer thanks
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
My opinion:

Detailed Answer:
Hi again,

Let me explain that after the Holter analyzing computer has drawn its own conclusions, as a general the technician caring of the test results will focus primarily on clarifying whether the machine analyzing is lacking any precision.

In general, the Holter computer almost always includes a few ECG errors (so called artifacts).

So, he (she – the technician) would carefully consider reviewing first any defined arrhythmic or conductance disturbances (including those 2 supposed PACs).

If the ECG recordings are of sufficient high quality, then it is rationale to believe that the absence of any other rhythm disturbances is correctly adjudicated by the machine.

Nevertheless, it is mandatory that the technician should take a look at the entire ECG recordings data (even if no arrhythmic events are concluded by the machine).

Those two PACS even if they were really present would signify nothing; they are quite common in each of us. No health disorders would be concluded by just two PACS.

So, once again relax and don’t worry about!

Regarding the treadmill test, I would like to review the entire conclusions and also associated registered ECG recordings because those ST depressions may be up sloping horizontal or down sloping, may be located just in the inferior or lateral leads as well as anterior leads; they may be due to a pure hypertensive response and signify nothing.

I would like to explain you that an exercise stress test would be diagnostically beneficial if the patient has a suspicious clinical angina coupled with distinct coronary risk factors.

Otherwise, it could bring to some misleading results.

So I would prefer to directly review your treadmill test results.

Could you upload it here for a second professional opinion?

I remain at your disposal for any further discussions.

Hope you are having a pleasant weekend!


Dr. Iliri

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


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