In the last issue, I told you how a steroid taper for a skin rash may have shaped the heart rate my cardiologist wants to medicate.
Today, I want to go back to where that story started: the heart monitor.
In June, I wore a Holter monitor for seven days. Wires taped to my chest, a small recorder, every heartbeat captured.
Three months later, I finally sat down with a cardiologist to go over the results. Here's the official summary, in his words:
"Sinus rhythm with rare ectopy. Single 4-beat atrial run and single 6-beat nonsustained ventricular tachycardia episode auto-detected. No patient-triggered events."
I read it the way most of us read medical reports: looking for the words that mean "you're in trouble." One phrase jumped out: nonsustained ventricular tachycardia.
I didn't know exactly what it meant. But "ventricular" means the lower chambers, the ones that pump. And "tachycardia" was the word the ER gave me in May. For a heart attack survivor, those two words together sound like the start of a very bad sentence.
What it actually was
Six fast heartbeats in a row. At 4:19 in the morning. While I was asleep.
It lasted about three seconds. Then my heart went back to its normal rhythm on its own. That's what "nonsustained" means.
I never felt it. I never pressed the button the monitor gives you to mark symptoms. If that machine hadn't been on my chest, I would never have known.
[INSERT: Amazfit sleep chart, night of June 8–9, with the 4:20 AM line]
My watch didn't catch it either. At 4:20 AM, it just shows me in light sleep. Three seconds is too fast for a wrist tracker. That's exactly why the Holter exists.
What turned fear into understanding
Here's what I've learned since, and it changed how I feel about those six beats:
My heart pumps normally. The September echocardiogram measured how strongly my heart pumps. My ejection fraction was 55%, which is in the normal range. That's the biggest factor in how doctors read a finding like this.
It happened at rest. Rhythm problems from a new blockage tend to show up when the heart is working hard. I was asleep.
I had no symptoms. None.
The rest of the summary was good news. "Rare ectopy" means extra beats were infrequent, and one short run from the upper chambers is common.
Put together, that's about the most reassuring version of this finding someone with my history could get.
Why both my doctors were right
My primary care doctor, Dr. Marsh, saw one short event and wasn't too worried.
My cardiologist, Dr. Senske, took it more seriously. Five years ago, one of my arteries was 100% blocked, and my heart still carries scar tissue from that night. A cardiologist reads six beats in a heart like mine differently. That's his job.
They were both right. Reassuring doesn't mean ignore it. The Coreg decision is still open, and I'll make it with him, after the sleep study I'm still waiting for.
If your own report says something you don't understand, these three questions are a good place to start:
What's my ejection fraction?
When did this happen, and what was I doing at the time?
Does this change anything for me?
Don't wait for an appointment if you have fainting or near-fainting, palpitations that don't stop, chest pain, or unusual shortness of breath. Get seen right away.
I never felt those six beats. A machine caught what I couldn't.
That's the case for data. It's also the case for having someone who will sit down and explain it.
I'm not a doctor, and this isn't medical advice. Your cardiologist has your full picture.
Have you worn a heart monitor? What did nobody explain to you? Hit reply. I read every response.
One more thing. From now on, I'm ending every Thursday letter with three small things: what I enjoyed, what I worked through, and what mattered.
This week's happiness check
Enjoyment: An old friend called me this week. We hadn't talked in about ten years. He'd been reading these letters and wanted to check in on me.
Satisfaction: Finally understanding a report that scared me. It took three months, an echo and a lot of reading, but the struggle was worth it.
Meaning: I write these so the next survivor who reads “NSVT” on a report doesn't have to be scared alone.
Dennis
Cardiac Survivor · Your Friend in Recovery
Spokane, Washington
P.S. I saw my cardiologist yesterday to go over my echo results. Next Tuesday, I'll tell you what I learned, why I'm still waiting for a sleep study five months later.
P.P.S. New here? The glossary has plain-English definitions of Holter monitor, NSVT, ejection fraction and every other term I use: newsletter.cardiacsurvivor.org/p/glossary