- Echocardiograms (ECHOs)
- Loop Event Monitoring
- Holter Monitoring
When most people think of heart monitoring, they picture a patient lying in a hospital bed with electrodes taped all over his body. While hospitals and clinics often do monitor their patients' heart activity, doing so doesn't always uncover the main problem. Many times, that's because the pains or unusual sensations that a patient's been noticing only occur when he's going about his regular, day-to-day activities. Also, such symptoms can be so intermittent that the chances of catching them on a monitor in a hospital are incredibly slim. For this reason, ambulatory heart monitors and recorders are often given to patients for 24-hour to 48-hour periods of time; such monitors can be worn as the patient goes about his everyday activities, and can record abnormalities in the electrical activity of the heart so that doctors can get a better idea about what is happening. Below, we explore the various types of heart monitors that are in use today, with a special focus on Holter monitoring.
Under normal circumstances, the heart contracts in response to the even, uniform spread of electrical activity from specialized heart cells called pacemaker cells. At any given time, there is a regular amount of electrical activity on the surface of the heart. This activity can be monitored and picked up with an electrocardiogram (ECG), which produces a surface map of that activity. An echocardiogram (ECHO) monitors sound waves to create a moving picture of the activity of the heart. Ambulatory electrocardiograms and echocardiograms refer to devices that can be worn while a patient is mobile and going about his regular activities. They fall into two main categories: intermittent electrocardiograms and continuous electrocardiograms.
When unusual heart activity symptoms occur very infrequently, intermittent electrocardiograms are often prescribed. These devices can be used for relatively lengthy periods of time, up to 48 hours in many cases. The information that they collect can be sent via phone to a physician. An event monitor is one type of intermittent electrocardiogram. It doesn't continually record the activity of the heart; instead, it "kicks in" when a patient presses a button on the device that he is wearing. In other words, whenever a patient feels an unusual symptom occurring, he presses a button and the event monitor starts recording.
Another very popular type of intermittent electrocardiogram is known as a loop recorder. These devices continuously record a patient's heartbeats. When a symptom occurs, the patient presses a button which triggers the recording of the heart's rhythm. Loop recorders are most commonly prescribed for patients who frequently lose consciousness due to their heart symptoms, as a patient can press the button upon regaining consciousness which then records the pertinent data for later examination by a physician.
Continuous recorders are, by far, the most common heart monitors prescribed today. Such a device can provide a 24- to 72-hour-long record of the heart's electrical signals. When in the hospital, a normal electrocardiogram will record a scant 40 or 50 heartbeats; a continuous recorder, on the other hand, can record as many as 100,000 heartbeats in a single 24-hour period. In this way, they provide a valuable record that physicians can use to diagnose potential heart problems, and are far more likely to detect such problems since they continuously record. Without question, the Holter monitor is the most common heart recording device in use today. If you are experiencing random symptoms that could be heart-related, there's a very good chance that your doctor will prescribe a Holter monitor.
What Is Holter Monitoring?
Holter monitoring is the continuous recording of the heart's rhythm, or an ambulatory electrocardiogram, and is usually performed over the course of a 24-hour period. Optimally, such a device will record the activity of the heart for a single day and a single night. Electrodes are attached to the chest; leads extend from those electrodes into a small recording device. The goal of a Holter monitor is to monitor how the heart responds to normal, everyday activity; in this way, a doctor can get a snapshot of how a patient's heart performs when he engages in various day-to-day activities. During typical activities like exercise, sex and sleep, a predictable pattern of electrical activity occurs within the heart. A Holter monitor can record anomalies in such patterns, bringing potential heart problems to light - or ruling them out.
Why Is Holter Monitoring Used?
When a patient complains about chest pains, heart palpitations, arrhythmias, blackouts, dizziness and other symptoms, his doctor may recommend a Holter monitor in order to determine whether unusual heart activity is to blame. Such symptoms often occur sporadically and in an unpredictable way; since a Holter monitor can be worn for 24, 48 and even 72 hours at a time, it increases the odds that a patient will be able to successfully record their heart's activity during such episodes.
Using A Holter Monitor: What To Expect
If your doctor prescribes a Holter monitor, you should be as prepared as possible by learning about what to expect when wearing one. Below, the most important things to keep in mind are outlined for your convenience:
· Electrode pads will be attached at your physician's office. Patients are advised to bathe prior to arrival, and are asked not to apply any lotions or oils to the skin as they can make attaching the electrode pads more difficult. For men, a hairy chest might need to be shaved before the electrode pads are attached. Once the pads are successfully attached, thin lead wires that extend from each one are plugged into a small recording device. The recording device is commonly attached to the patient's belt or is hung in a pouch over the neck and shoulders. From this point, until removal, the patient may not bathe or shower as the Holter monitor cannot get wet.
· Upon leaving the office, patients are advised to go about their everyday activities as usual. Optimally, they should pretend that they aren't even wearing a monitor. The goal of Holter monitoring is to catch irregularities in heart rhythm that occur during day-to-day activities. Patients are told to keep a journal or small notepad handy, in which they can note the precise times that specific activities, like walking the family pet or getting exceptionally upset, happen. Also, any time a symptom is noticed, the patient should record the exact time in the journal or notepad. For instance, if a patient experiences a skipped heartbeat, discomfort in the chest or starts to feel dizzy, he should note the time as precisely as possible in his journal. The Holter monitor regularly stamps its EKG strips with the time; events, symptoms and activities can be matched up later with the notes that the patient has kept in his journal.
· For best results, patients are advised to wear loose, comfortable clothing when undergoing Holter monitoring. While sleeping, patients should try to sleep on their backs with the monitor carefully placed beside them or on a nearby table. If a lead wire becomes disconnected, a light on the Holter monitor will flash. Many times, patients can reconnect the wire themselves; if not, they should visit their doctor's office as soon as possible. Under no circumstances should the monitor be allowed to get wet, and patients should avoid using things like electric shavers, electric blankets and having X-rays done, since those things can interfere with the monitoring system.
· Before leaving the doctor's office with their Holter monitor, patients will be given a return appointment time. When that time comes, the patient will return to the doctor's office. It is important to return to the office at the specific time so that the data from the Holter monitor can be successfully downloaded. The doctor will use that data, along with the journal or notebook that you have kept, to pinpoint any possible irregularities or potential problems. The test and the results of the Holter monitoring will be analyzed, and your physician will schedule a consultation with you to discuss the results.
Heart monitoring and recording allow doctors to monitor the heart activities of their patients via electrocardiogram as they go about their daily business. This is an invaluable tool that can help uncover potential heart problems before they turn into much more serious problems. Through Holter monitoring, loop recording and other popular methods, the health and well-being of people around the world is being taken care of more efficiently and effectively than ever.