HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Does The Following Holter Monitoring Report Suggest?

Posted on Sat, 14 Feb 2015

Question: Hello,
Following is my mother's(age 61) Holter Monitoring report --

1. 24 Hrs. Holter monitor reveals sinus rhythm with frequent sinus pauses of >2.5 sec in duration, interrupted by nodal ectopics noted.
2. Minimum & maximum HR of 30 and 94 bpm and an average HR of 54 bpm.
3. No evidence of any tachyarrythmia & bradyarrhythmia noted.
4. Pateint remained asymptomatic throughout the test. No significant ST change.

Can you please suggest whether pacemaker is only treatment or not?

Answered by Dr. Anantharamakrishnan (6 hours later)

Brief Answer:
YES

Detailed Answer:
Hi friend
Welcome to Health Care Magic

True
Such low rate and long pauses dictates its use
Pace maker is the only option
There is no alternative

Good luck
God bless you

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Anantharamakrishnan (4 hours later)

Thanks for your reply. Before having pacemaker my mother did not have any symptoms except vertigo. After implanting pacemaker still she was having vertigo. Doctors prescribed Stugil thrice a day but still it was there. Also Angiotek and Flavedon MR was prescribed. just few days ago she became senseless twice. Pacemaker recording showed VT/VF . Then lower threshhold of PM was raised to 90 from 60. After that no VT/VF occurred. She is still asymptomatic and just complining about vertigo. Please suggest what should I do.

Answered by Dr. Anantharamakrishnan (1 hour later)

Brief Answer:
May need more investigations...

Detailed Answer:
Hi

There probably were several factors, contributing to her vertigo - pace maker has tackled one… / It is reassuring to see that VT/VF disappeared after changing the pacemaker parameters. / If the vertigo is not related to the arrhythmia, one needs to investigate further….

The body's balancing mechanism is in the inner ear. An ENT (Ear Nose Throat) specialist may have to evaluate - they have special tests to confirm or exclude the contribution of the ear. This is particularly important in the presence of tinnitus (ringing in the ears).

If the ear is excluded, neurologic consultation is in order. Brain scan and Carotid/vertebral Doppler, EEG may all be needed.

If the problem continues and if there are no clues, one may have to go for Electro Physiological Studies (EPS) for the heart…

The treating doctor alone could conclude better, based on the total clinical picture

Regards

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Shanthi.E