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What Does Holter Monitor Indicating Sinus Rhythms Indicate?
Question: Hello,
My mother(age 61) has undergone pacemaker surgery on first week of November,2014. One ECG report was bad and following was Holter 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.
After pacemaker implantation first 2 months my mother complained of dizziness , vertigo . But, they were not present to that extent before pacemaker. Then, on January,2015 first week she became senseless twice . Investigation said VT/VF.
She was admitted again and pacemaker threshold was set to 90 which was 60 initially. After that she was quite fine with no VT/VF and significantly less vertigo.
Now in last checkup 5 days ago, doctor again lowered pacemaker threshold to 70 from 90. First 3 days were ok but now again she is complaining vertigo with high intensity. I consulted with doctor and was advised to wait because no blackout was there.
She is currently taking Metocard XL 50.
My question is--
1. Should I ask dr to increase threshold to 90 again?
2. what may be the problem if pacemaker threshold stays at 90?
3. Was pacemaker implantation required?
4. Why she is still not fully cured? is it side effects of pacemaker?
5. Is it sign of unnecessary pacemaker implantation?
Thanks.
My mother(age 61) has undergone pacemaker surgery on first week of November,2014. One ECG report was bad and following was Holter 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.
After pacemaker implantation first 2 months my mother complained of dizziness , vertigo . But, they were not present to that extent before pacemaker. Then, on January,2015 first week she became senseless twice . Investigation said VT/VF.
She was admitted again and pacemaker threshold was set to 90 which was 60 initially. After that she was quite fine with no VT/VF and significantly less vertigo.
Now in last checkup 5 days ago, doctor again lowered pacemaker threshold to 70 from 90. First 3 days were ok but now again she is complaining vertigo with high intensity. I consulted with doctor and was advised to wait because no blackout was there.
She is currently taking Metocard XL 50.
My question is--
1. Should I ask dr to increase threshold to 90 again?
2. what may be the problem if pacemaker threshold stays at 90?
3. Was pacemaker implantation required?
4. Why she is still not fully cured? is it side effects of pacemaker?
5. Is it sign of unnecessary pacemaker implantation?
Thanks.
Brief Answer:
no to all your questions
Detailed Answer:
No to most of your questions. As she had significant pauses on holter, it's clear indication for pacemaker implantation.
Occasionally arrhythmia can be part of pacemaker what we call pacemaker mediated tachycardia, but more often it's likely to be associated disease. as for changing thresholds if treating cardiologist feels not needed than it won't be. The parameters will be changed according to need of patients and there will not any major impact of keeping them high or low it would be more to do with what's needed.
Hope this has answered your questions.
Regards
no to all your questions
Detailed Answer:
No to most of your questions. As she had significant pauses on holter, it's clear indication for pacemaker implantation.
Occasionally arrhythmia can be part of pacemaker what we call pacemaker mediated tachycardia, but more often it's likely to be associated disease. as for changing thresholds if treating cardiologist feels not needed than it won't be. The parameters will be changed according to need of patients and there will not any major impact of keeping them high or low it would be more to do with what's needed.
Hope this has answered your questions.
Regards
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Brief Answer:
Fever needs to investigated
Detailed Answer:
If her scalp is getting heated it suggests fever and you need to work up for fever. I will suggest to see a physician.
And about her cataract, my expertise are limited in the field of ophthalmology. It would be better to ask an ophthalmologist. But yes you do need to see ophthalmologist.
Fever needs to investigated
Detailed Answer:
If her scalp is getting heated it suggests fever and you need to work up for fever. I will suggest to see a physician.
And about her cataract, my expertise are limited in the field of ophthalmology. It would be better to ask an ophthalmologist. But yes you do need to see ophthalmologist.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Prasad
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