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Heart & Cardiology/Paroxysmal Ventricular Tachycardia Questions


Questions: Should I wait 3 weeks?  What constitutes a short run?  (details below)


I'm a 54-year-old male.  I don't have any health issues except that I've been on sertraline for 15 years for generalized anxiety disorder and I have obstructive sleap apnea and wear a CPAP most nights.  

Recently I started experiencing palpitations and my doc had me wear a Holter for 24 hours.  After he looked at results he referred me to a local cardiologist saying that I had Paroxysmal Ventricular Tachycardia.  When I read about this arrhythmia it sounds pretty serious, but the earliest I can get in with the cardiologist is 3 weeks out.  My question is: is it a reasonable risk to wait 3 weeks?  I have 4 kids and I don't want to over-react but I also don't want to take any unnecessary risks with this.  The cardiologist has not looked at the Holter results yet.

Below I will key in the summary from the Holter report, which might give some more context (by the way, when I wore the Holter I had a pretty good day, with none of my episodes amounting to more than a flutter.  Some days I'll have 1, and usually not more than 1, episode lasting about 10 minutes, but I didn't have one of those while wearing the Holter; related question: what constitutes a "short run").

The average heart rate was 58 with a max of 125 and a min of 39.

Tachycardia (>120) was noted <1% of the time.  There were less than one Tachycardia minutes with the longest episode occurring for less than one minute.

Bradycardia (<50) was noted 22.4% of the time.  There were 323 Bradycardia minutes with the longest episode occurred for 15 minutes.

2 pauses exceeding 2.5 seconds were noted.  The longest pause of 2.7 seconds occurred at a 00:37:05.

341 Ventricular ectopics, which represented .39% of the total beat count, were noted.  Ventricular ectopics were observed as 268 isolated beats and as 16 couplets.  11 runs were noted.  None of the ventricular beats occurred in bigeminal cycles.  3 of the ventricular beats occurred in 1 trigeminal cycle.

138 supraventricular ectopics, which represented .16% of the total beat count, were noted.

2 episodes of ST depression (defined as -1.0 or more for longer than 1 minute) were noted in channel 2.  The maximum depression of -1.4 occurred in channel 2 at 07:45.

Channel 1 was the primary channel during the analysis.

So, if you think I should work hard to get an earlier appointment please tell me.  I'm going to be in a bigger city next week and maybe I could make it happen.

Hi Ross,
There is nothing to suggest you cannot wait for your cardiology appointment. Read this about palpitations and PVCs:
I cannot judge whether an earlier appointment is necessary from what you have told me, and I don't think PAT has been proven. Meanwhile you can ask your GP to make sure your blood work is done, and maybe have him schedule an echocardiogram in advance to look at your heart function:
Hope this helps,
Dr T

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