Does NSVT necessitate a Cardiac Cath?

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Submitted by Dr T on December 31, 2011 – 11:34am

Question: 
Hi,My husband has been having some dizziness when he stands from a squatting position and only then. He had an endoscopy done  not to long ago and his pulse rate was low and in the 40’s. As his wife and a healthcare person I thought since he is 54 he should be worked up . So he had a stress echo and that was normal. He had a 24 hr halter monitor and the report was that they saw some irregular heart beats and dx him with NSVT. So now they want him to have a cardiac cath. I am quite upset about this. Unfortunaltely I was not at the consultation when this information was explained  to my husband. Would this be the next step or should I get another opinion? I will speak with the cardioligist about this but they are pushing to have this done.Can you help me understand this condition. Thank ou so much.

Hi Julie,
I agree with you, there is no real indication he needs a cath! If necessary because of other risks of heart disease, a very reliable and much simpler test is CTCA. While NSVT may indicate heart disease, the stress echo and Holter monitor have excluded this.  His symptoms are much more suggestive of orthostatic hypotension, usually benign and easily avoided by not squatting! However, I am a little concerned about the bradycardia, because the heart rate’s normal response to orthostatic hypotensionis to speed up. Is his heart rate always that slow?

Hope this helps,
Dr T

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