Brief Answer:
Nothing dangerous from your Holter monitoring.

Detailed Answer:
Hello,

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that 58 apb's (atrial premature beats), 31 vpb's (ventricular premature beats) and 4 atrial couplets (double consecutive premature beats) are considered non-complex arrhythmic events and judging from their non-frequent rare of occurrence, they are considered clinically non-significant.

So, nothing to worry about, they are quite harmless.

From the other hand, runs of atrial tachycardia are considered complex arrhythmia, but they are supraventricular events so not considered dangerous or life-threatening.

Furthermore, there are only 2 runs of 3 complexes. So clinically insignificant (they don't produce any important unpleasant feeling or adverse impact on hemodynamic status.

So, your Holter monitoring doesn't represent any serious arrhythmic events.

Coming to this point I would recommend you to ask your attending doctor for a cardiac ultrasound (ECHO) to rule in/out any cardiac structure abnormality; also additional tests like:

- complete blood count (for excluding possible anemia),
- PCR (for any inflammation),
- blood electrolytes level,
- thyroid function tests,
- fasting blood glucose,
- renal function tests (BUN & creatinine),
- AST & ALT,
- chest X ray study

to investigate for any possible responsible cause of the above Holter findings.

According to the above mentioned tests results, an appropriate therapy could be addressed.

Hope to have been helpful to you!

In case of any further uncertainties, do not hesitate to ask me!

Wishing you all the best for the New Year!

Kind regards,

Dr. Iliri

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Brief Answer:
Opinion as follows:

Detailed Answer:
Hi again,

I would explain that the arrhythmic events registered by your Holter test can’t explain the syncope.

Other more complex arrhythmia such as ventricular arrhythmia (ventricular tachycardia) but also a sudden supraventricular arrhythmia with a fast ventricular response could be a responsible cause of syncope in certain circumstances.

Several reasons of syncope should be excluded (neurological, vaso-vagal syncope, hypoglycemia, etc.)

Even a vasodilator response to drinking wine, may cause syncope.

Regarding your recorded Holter findings, thyroid gland may play a role.

So its functional investigation should be part of the differential diagnosis work up.
For this purpose, I recommend dosing thyroid hormones like FT3, FT4, TSH.

I suggest to discuss with your attending physician on the above mentioned tests (at the beginning of our thread).

Regards,

Dr. Iliri

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