24 Hour Holter Report

Transcription

1 Mass Veterinary Cardiology Services Inc 35 Suffield St Agawam, MA / Exam Date: OCT :19am Record No: 7581 Provider: NANCY MORRIS DVM, DACVIM-C Medical Record Notes Patient: GRIFFON Age: 6 yrs 7.4 mns Weight: lbs. kg ALISSA WEAVER Problem: HOLTER STUDY BREEDING CLEAR Location: No Entry Species: CANINE Breed: DOBERMAN PINSCHER Provider: NAM Record: Page: 1 Gender: M DOB: FEB 2 7 Age: 6 yrs 7.4 mns Weight: lbs. kg 24 Hour Holter Report Date study performed: The total holter scan time was 24:1. The time analyzed was: 22:47. The scan quality was good. Mean Heart Rate: 74 High Heart Rate: 22. Low Heart Rate: 35. Heart Beats/24 hrs: 1566 There were a total of 2325 singular, Ventricular Premature Beats (VPC s or PVC s) during the monitoring period. There were no couplets, triplets nor runs of ventricular tachycardia during the monitoring period. All other periods of slow heart rate (Bradycardia) and fast heart rate (Tachycardia) correlated appropriately with the activity reported in the diary. Other findings: There were 1896 singular Atrial premature beats during the monitoring period. Diagnosis: Marked improvement in holter findings on the current medications though still not completely normal. Recommendations: Results discussed with owner but reporting delayed due to trip to California for the Doberman nationals. Discussed approaches with owner in that to date the appearance of his heart on echo suggests degenerative valvular disease with normal systolic function and measurements. Given the ventricular arrhythmias, I am concerned that we have both degenerative valvular disease and early DCM coexisting. After much discussion: continue Mexilitine at 15 mg PO TID, give with some food and increase Sotalol to full 8 mg tab PO BID. Repeat holter ASAP to see if this change provides further improvements. If medication changes do not provide further improvement or if the arrhythmias worsen on these changes, I recommend adding in Pimobendan at 1 mg PO BID. There were concerns early on with usage of Pimobendan that it could potentially worsen ventricular arrhythmias but there publications specific to Dobermans which have shown just the opposite. By increasing pump function, a reduction in ventricular arrhythmias can be seen in Dobermans affected with DCM--the main issue in Griffon is that to date we have not found any systolic dysfunction and so whether or not this would be of benefit to him is not clear cut. Continue Benazepril at 15 mg once daily. I am sorry for the delay in your receiving the actual report.

2 CANINE HOLTER MONITORING REPORT Copyright NorthEast Monitoring Inc All data printed in the reports should be reviewed by a qualified physician. Patient Name: GRIFFIN Holter Monitor Report Physician: Date of Birth: Scan Number: DOBERMAN ID #: 2 Date Recorded: 9/28/213 Age: 6 Years Date Processed: 1/1/213 Sex: M Recorder Num: HookupTech: Indications: alissaweaver@verizon.net Medications: GRIFFIN was monitored for a total of 24:1 hours. The total time analyzed was 22:47 hours. Start time was 7:8PM1. There were a total of 1556 Beats. (2.31%) were Ventricular beats, (1.88%) were Supraventricular beats, and less than 1% were Paced beats. Mean Heart Rate: 74 Maximum Heart Rate: 22 at 6:37:13PM2 Minimum Heart Rate: 35 at 3:52:39PM2 Pauses: (Greater than 5 sec.) Ventricular Ectopy Supraventricular Ectopy 2% : 2325 : % Early/Late: 2288 / 37 Single: 1896 Pairs: Pairs: Runs: Runs: Beats in Runs: Beats in Runs: # # Longest 7:8PM1 Longest 7:8PM1 Fastest 7:8PM1 Fastest 7:8PM1 RonT: Aberrant: RR Variability ST Absolute SDNN: 36 ms Depression : mm pnn5: % Elevation : 8.87 mm RMSSD: 33 ms Comments: PVC SUMMARY SINGLES=2325 PAIRS= RUNS= Physician's Signature:

3 Copyright NorthEast Monitoring Inc All data printed in the reports should be reviewed by a qualified physician. Patient: GRIFFIN Page 2 GENERAL PROFILE INTERVAL HEART RATE TOTAL VPB VPB RUNS SVPB SVPB RUNS TIME STARTING LO MEAN HI BEATS TOTAL PAIRS VT TOTAL PAIRS SVT PAUSES ANALYZED 7:8PM :35 8:PM :55 9:PM : 1:PM :59 11:PM :58 12:AM :56 1:AM :55 2:AM :58 3:AM :58 4:AM :59 5:AM :59 6:AM :59 7:AM :59 8:AM :52 9:AM :55 1:AM :56 11:AM :58 12:PM :59 1:PM :59 2:PM : 3:PM :59 4:PM :59 5:PM :56 6:PM :42 7:PM :7 SUMMARY : :47

4 Copyright NorthEast Monitoring Inc All data printed in the reports should be reviewed by a qualified physician. Patient: GRIFFIN Page Heart9 Rate 8 BPM VPB 6 per 5 MIN VT 2 BEATS15 /MIN SVPB 6 per 5 MIN SVT 2 BEATS15 /MIN 1 5 AF HEART RATE TREND (24 hours) 9pm1 11pm1 1am2 3am2 5am2 7am2 9am2 11am2 1pm2 3pm2 5pm2 7pm2 9pm1 11pm1 1am2 3am2 5am2 7am2 9am2 11am2 1pm2 3pm2 5pm2 7pm2 9pm1 11pm1 1am2 3am2 5am2 7am2 9am2 11am2 1pm2 3pm2 5pm2 7pm2 9pm1 11pm1 1am2 3am2 5am2 7am2 9am2 11am2 1pm2 3pm2 5pm2 7pm2 9pm1 11pm1 1am2 3am2 5am2 7am2 9am2 11am2 1pm2 3pm2 5pm2 7pm2

5 Copyright NorthEast Monitoring Inc All data printed in the reports should be reviewed by a qualified physician. Patient: GRIFFIN Page 4 CRITICAL EVENTS 7:1PM1 VPB VPB PAIRS NOT PRESENT 4 2 VTAC NOT PRESENT 2 1 7:9PM1 SVPB SVPB PAIRS NOT PRESENT 2 1 SVT NOT PRESENT 2 1 PAUSES NOT PRESENT 2 1

6 Copyright NorthEast Monitoring Inc All data printed in the reports should be reviewed by a qualified physician. Patient: GRIFFIN Gain[ 1.] ECG 25 mm/sec (ALL) Page 5 FULL-SIZED STRIPS 7:9:8PM1 SVPB HR = :24:47PM1 Early VPB HR = :28:21PM1 SVPB HR =

7 Copyright NorthEast Monitoring Inc All data printed in the reports should be reviewed by a qualified physician. Patient: GRIFFIN Gain[ 1.] ECG 25 mm/sec (ALL) Page 6 8:1:7PM1 Early VPB HR = :2:13PM1 Early VPB HR = :28:38PM1 SVPB HR =

8 Copyright NorthEast Monitoring Inc All data printed in the reports should be reviewed by a qualified physician. Patient: GRIFFIN Gain[ 1.] ECG 25 mm/sec (ALL) Page 7 8:51:1PM1 VPB HR = :33:5AM2 Early VPB HR = :12:58AM2 Early VPB HR =

9 Copyright NorthEast Monitoring Inc All data printed in the reports should be reviewed by a qualified physician. Patient: GRIFFIN Gain[ 1.] ECG 25 mm/sec (ALL) Page 8 2:49:4AM2 Bigeminy HR = :57:13AM2 Bigeminy HR = :31:49AM2 Early VPB HR =

10 Copyright NorthEast Monitoring Inc All data printed in the reports should be reviewed by a qualified physician. Patient: GRIFFIN Gain[ 1.] ECG 25 mm/sec (ALL) Page 9 9:55:41AM2 Early VPB HR = ::1AM2 One per hour HR = ::1PM2 One per hour HR =

11 Copyright NorthEast Monitoring Inc All data printed in the reports should be reviewed by a qualified physician. Patient: GRIFFIN Gain[ 1.] ECG 25 mm/sec (ALL) Page 1 2::1PM2 One per hour HR = ::1PM2 One per hour HR = :52:39PM2 Min. heart rate HR =

12 Copyright NorthEast Monitoring Inc All data printed in the reports should be reviewed by a qualified physician. Patient: GRIFFIN Gain[ 1.] ECG 25 mm/sec (ALL) Page 11 4::1PM2 One per hour HR = ::1PM2 One per hour HR = :37:13PM2 Max. heart rate HR =

13 Copyright NorthEast Monitoring Inc All data printed in the reports should be reviewed by a qualified physician. Patient: GRIFFIN Gain[ 1.] ECG 25 mm/sec (ALL) Page 12 7::PM2 One per hour HR =