Holter Monitor/Event Monitor
Procedure Overview
What is a holter monitor?
The holter monitor is a type of electrocardiogram (ECG or EKG) used to monitor the EKG tracing continuously for a period of 24 to 48 hours or longer. An EKG is one of the simplest and fastest procedures used to evaluate the heart. Electrodes (small, plastic patches) are placed at certain locations on the chest. When the electrodes are connected to an EKG machine by lead wires, the electrical activity of the heart is measure, interpreted, and printed out for the physician’s information and further interpretation.
What is an event monitor?
Event monitoring is very similar to holter monitoring, and is often ordered for the same reasons. With an event monitor, you wear EKG electrode patches on your chest, and the electrodes are connected by wire leads to a recording device. The event monitor does not record until you feel symptoms and trigger the monitor to record your EKG tracing at that time. An auto-trigger event monitor may be used to record rhythms when symptoms are rare or suspected to occur during sleep. The auto-trigger event monitor automatically records rhythm events and can be manually activated if you experience symptoms.
Reasons for Monitoring
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To evaluate chest pain not reproduced with exercise testing
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To evaluate other signs and symptoms which may be heart-related, such as fatigue, shortness of breath, dizziness, or fainting
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To identify irregular heartbeats or palpitations
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To assess risk for future heart-related events in certain conditions
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To assess the function of an implanted pacemaker
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To determine the effectiveness of therapy for complex arrhythmias
Risks of Procedures
The holter and event monitors are noninvasive methods of assessing the heart’s function. Risks associated with these procedures are rare.
Prolonged application of the adhesive electrode patches may cause tissue breakdown or skin irritation at the application site.
There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to wearing the monitor.
Certain factors or conditions may interfere with or affect the results of the holter monitor reading. These include, but are not limited to the following:
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Close proximity to magnets, metal detectors, high voltage electrical wires, and electrical appliances such as microwave ovens
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Smoking, certain medications
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Excessive perspiration, which may cause the leads to loosen or detach
What You Can Expect
Before monitor placement
Monitors are generally performed on an outpatient basis. However, inpatients are monitored via this method as well. Fasting is not required for this procedure.
Upon arrival to the Noninvasive Cardiology department, the procedure will be explained to you and opportunities to ask any questions will be given.
Based on your medical condition, your physician may request other specific preparation.
During monitoring
Generally, a holter monitor or event monitor recording follows this process:
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You will be asked to remove any jewelry or other objects that may interfere with the reading.
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You will be asked to remove clothing from the waist up in order to attach the electrodes to your chest. The technician will ensure your privacy by covering you with a sheet or gown and exposing only the necessary skin.
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If your chest is very hairy, the technician may shave small patches of hair, as need, so that the electrodes will stick closely to the skin. Your skin will be cleansed with an abrasive alcohol pad.
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Electrodes will be attached to your chest. The monitor will be connected to the electrodes with lead wires. It may be clipped to a belt or pocket or worn around the neck.
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Once you have been hooked up to the monitor and given instructions, you can return to your usual activities, such as work, household chores, and exercise, unless your physician instructs you differently. This will allow your physician to identify problems that may only occur with certain activities.
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You will be instructed to keep a diary which will include time of your activities and/or symptoms. For example: “8:00 a.m. – walking/chest pain and palpitations”; or “12:00 p.m. – running on the treadmill.” Not all activities need to be listed. Only those activities with accompanying symptoms or those which may increase your heart rate.
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Some examples of symptoms include:
After the monitoring
You should be able to resume your normal diet and activities, unless your physician instructs you differently. Generally, there is no special care following monitor recording. Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation. Notify your physician if you develop any chest pain, shortness of breath, dizziness, or fainting.
Return the monitor and diary, as instructed at the end of the recording period.
Your scan will be processed and then read by a cardiologist. Your ordering physician will have results available to them within three business days of reading.