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Holter monitoring |
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What is Holter Monitor?
A Holter monitor is a continuous tape recording of a patient's EKG
for 24 hours. Since it can be worn during the patient's regular
daily activities, it helps the physician correlate symptoms of
dizziness, palpitations (a sensation of fast or irregular heart
rhythm) or black outs. Since the recording covers 24 hours, on a
continuous basis, Holter monitoring is much more likely to detect
an abnormal heart rhythm when compared to the EKG which lasts less
than a minute. It can also help evaluate the patient's EKG during
episodes of chest pain, during which time there may be telltale
changes to suggest ischemia (pronounced is-keem-ya) or reduced
blood supply to the muscle of the left ventricle.
How do
I prepare for the Test?
The only requirement is that the patient wear loose-fitting
clothes. Buttons down the front of a shirt or blouse is
preferable. This makes it convenient to apply the EKG electrodes,
and also comfortably carry the monitor in a relatively discreet
manner
How is the Test Performed?
The chest is cleansed with an alcohol solution to ensure good
attachment of the sticky EKG electrodes. Men with hairy chest may
require small areas to be shaved. The EKG electrodes (circular
white patches on the left) are applied to the chest. Thin wires
are then used to connect the electrodes to a small tape recorder.
The tape recorder is secured to the patient's belt or it can be
slung over the shoulder and neck with the use of a disposable
pouch. The recorder is worn for 24 hours and the patient is
encouraged to continue his or her daily activities. To avoid
getting the setup wet and damaging the recorder, the patient will
not be able to shower for the duration of the test. A diary or log
is provided so that the patient can record activity (walking the
dog, upset at neighbor, etc.) and symptoms (skipped heartbeats,
chest discomfort, dizziness, etc.) together with the time.
The Holter monitor has an internal clock which stamp the time on
the EKG strips. These can be used to correlate the heart rhythm
with symptoms or complaints. After 24 hours, the Holter monitor
needs to be returned to the laboratory. This can be removed by the
staff. However, if you live out of town or need to take a shower
before leaving the house, the monitor can be disconnected from the
electrodes and sent back to the laboratory, together with the
completed diary.
After returning the Holter Monitor
to the doctor's office, satellite clinic or hospital lab, the tape
is removed from the recorder and scanned by a technician. Multiple
EKG strips are recorded on paper together with a
computer-generated summary that provides details about the
patient's heart rate and rhythm during the recording. This
information is then provided to your doctor.
How long does it take?
It takes approximately 10 to 15
minutes to apply the monitor and less than 5 minutes to remove it.
The patient will also receive directions. Many monitors are also
equipped with an "event" button. Pressing the button during a
symptom (dizziness, for example) will help the technician print an
ECG from that precise time.
How safe is the test?
Holter monitoring is extremely safe and no different than carrying
around a small tape recorder for 24 hours. Some patients are
sensitive to the electrode adhesive, but no serious allergic
reactions are known
When will I get the results?
The report is provided to the physician, together with multiple
EKG strips after the tape has been scanned by the technician. If
the technician sees a rhythm that is life-threatening or
potentially dangerous the physician is informed immediately.
Otherwise, it may take a few days before you get the official
results from your physician's office. At that time, you may also
receive additional recommendations based upon the results of the
test. For example, a pacemaker may be recommended if a patient has
blackouts and the Holter monitor shows a seriously slow heart beat
during the test
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