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PVC's bigeminy in 3 year old

Trying to interpret my daughters recent holter report. She's been treated with atenolol yet the PVC's have picked up to 35% of her total beats. Is she at risk for sudden cardiac events with this pattern?
135,118 qrs complexes
48,483 ventricular ectopies representing 35% total qrs complexs
     31, 281 bigeminal cycles
She is three years old. We are going to see an electrophysiology team next week also an echo and repeat holter at that time. I'm worried she is at risk for sudden cardiac events. Is It possible? What questions should I ask the dr's next week? Thanks
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Avatar universal
Hi thanks for your comments. I actually have no idea the answers to most of the questions you asked but can always ask the doctors next week when we go in.
They actually pulled my daughter off of Ateonolol after this last holter. It caused bradycardia and low blood pressure on top of NOT controlling the bigeminy :/
From my understanding these are unifocal located in the left ventricle. It says NO VT and no higher grade ectopy on her interpretation. That is good. But I'm still worried of course...hoping they can figure it all out!
Thanks again for your time!
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995271 tn?1463924259
and....sure enough I have an addition.

I had a major PVC outbreak on 2009.  I tried everything.  I swear up and down that beta blockers (BBs) MADE THEM WORSE.  Atenolol is beta blocker.  There are some of us PVC suffers who have reported BBs making them worse.  All sorts of amateur theories, no studies.  So, perhaps experiment a bit with the BB?   gonna be a touchy subject with her doctors.

Some of the theory is that cartain PVCs (idiopathic, meaning no obvious cause) may be the result of low-grade inflammation of the heart.  This could be caused by viral illness, bacterial, endocrine issue, autoimmune issue....and the theory is that BBs can actually worsen inflammation.

Complete amateur guess.
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995271 tn?1463924259
I'm so sorry I can't offer any good advise, I don't know anything about pediatric heart rhythm issues.

I think with the tests so far, if they had seen indicators that would make the doctors think the rhythm could degrade into something harmful they would address it immediately, and there are tell-tale indicators.

From what I've learned over the years, with ventricular arrhythmia, the biggest indicators are:

QRS wave timing (how long does it take, longer = bad)
Measuring any bundle blocking
Ventricular ectopics:
  -Total load >20% could weaken the muscle over time, but can be reversed if treated
  -Are they isolated?  meaning, are there any that happen in couplets, triplets, nsvt, VT?  nsvt gets concerning, but could still be treatable.  VT is very concerning and would require an ICD.
  -When are the PVCs happening during a beat cycle, how close are they to the T wave?
  -Where are the PVCs originating from??  Unifocal means they are all coming from 1 spot, multifocal means they are originating in multiple spots.  Unifocal is obviously better because ablation has a higher chance.  Also better chances if they are originating in the right ventricle because these can be reached with a catheter easier than the left side. A common site for benign PVCs is called the "Right Ventricular Outflow Tract" or RVOT.  highest success rates for ablation are in the RVOT.

That's about all my knowledge dump I have for now.  Knowing me, I will probably think of something else in 5 minutes and post a follow-up.  :-)

Anways, good luck and stay tough for your daughter, give her big hugs for us.  I'm so sorry she has to go through this.
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