A Holter monitor is a type of ambulatory electrocardiography (ECG) device. It is used for the monitoring of the electrical activity of the cardiovascular system for at least 24 to 72 hours usually for two weeks at a time.
When it is used to study the heart, the Holter monitor records electrical signals from the heart via a series of electrodes attached to the chest—the electrodes are placed over bones to minimize artifacts from muscular activity. These electrodes are connected to a small piece of equipment that is attached to the patient’s belt or hung around the neck, keeping a log of the heart's electrical activity throughout the recording period.
The Holter system consists of the hardware and software. The hardware which is the monitor or recorder, records the signal while the software is used for review and analysis of the record. The Holter monitor continuously records throughout the entire period it is being worn. There is usually a “patient button” located on the front side allowing the patient to press it at specific periods such as when they are retiring to bed, when they fall ill or are taking medication, and so on. A special mark will be placed into the record so that the doctors or technicians can easily pinpoint these areas when analysing the signal.
A Holter monitor can be worn for many days without causing significant discomfort.
Why the need for Holter monitoring?
A doctor may ask the patient to use a Holter monitor if the doctor needs more information about how the patient’s heart functions than a routine electrocardiogram can give.
Where a person has signs or symptoms of a heart problem, for instance, an irregular heartbeat (arrhythmia) or unexplained fainting, their doctor may initially order a test called an electrocardiogram—a brief, non-invasive test that uses electrodes taped to the chest to measure the heart rate and check the heart's rhythm. However, an electrocardiogram may occasionally fail to detect any irregularities in the hear rhythm because the person is hooked up to the machine for only a short period of time. Therefore, if the person's signs and symptoms suggest that an occasionally irregular heart rhythm may be causing their condition, the doctor may proceed to recommend that they wear a Holter monitor for a day or so.
Over the period of time that the Holter monitor is worn, it may be able to detect irregularities in the heart rhythm that an electrocardiogram couldn’t detect.
A second instance is where a person has a heart condition that increases their risk of an abnormal heart rhythm. The doctor may also order that they wore a Holter monitor for a day or two even if they haven’t had any symptoms of an abnormal heartbeat.
Where a patient is already undergoing treatment for heart problems, the Holter monitor can aid their doctor in determining whether their medication is working or if changes need to be made. Additionally, it can also help the doctor to see why the patient might be experiencing other symptoms of irregular heartbeat such as dizziness, faintness, or the feeling like the heart is racing or skipping a beat.
Abnormal heart rhythms and other types of cardiac symptoms can come and go. This necessitates monitoring for a longer period of time to record these events. The Holter monitor enables the doctor to see how the heart functions on a long-term basis. This way, the doctor can determine if the heart is getting enough oxygen or if the electrical impulses in the heart are delayed or early.
The patient would be required to keep a diary of all the activities This will enable the doctor determine if changes in heart activity are related to the patient’s behaviours and movements. patient will, or other cardiac symptoms.
How painful is the procedure?
Holter monitoring is painless and the patient is encouraged to participate in their normal activities during the period of time they wear the Holter monitor. The Holter monitor is small with several wires or leads attached to it. The leads connect to electrodes that are placed on the skin of the chest with a glue-like gel. The metal electrodes conduct the heart's activity through the wires and into the Holter monitor, where it is recorded. The patient would wear a small pouch around their neck that holds the monitor itself.
Instructions will be given explaining how to take care of the monitor and what not to do while it is being worn. For example, patients will be directed to avoid activities that might lead to the monitor getting wet such as swimming. The doctor will also show the patient how to reattach electrodes if they become loose or fall off during the testing period.
What happens after the test?
After the testing time frame as recommended by the doctor has elapsed, the patient is to return to the doctor’s office to have the Holter monitor removed. The doctor will read the patient’s diary of activities recorded and analyse the results of the monitor. Depending on the results of the test, further testing may be required before a diagnosis is made.
The Holter monitor may reveal that the patient’s medication isn’t working or that their dosage needs to be altered if they are already taking medication for an abnormal heart rhythm.
Undergoing Holter monitoring is one of the best ways to identify potential heart problems or other issues. It has been found to be especially useful in detecting abnormal heart rhythms that are painless and unknown to the patient. And as always, the first step to take is to go for regular check-ups. The earlier an anomaly is discovered, the easier it is to correct or manage. Don’t forget to book an appointment with your doctor or health care provider now.
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