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Ambulatory Electrocardiography (Holter Monitoring; Ambulatory Monitoring)
Ambulatory Electrocardiography (Holter Monitoring; Ambulatory Monitoring)
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Ambulatory Electrocardiography (Holter Monitoring; Ambulatory Monitoring)
Category: Cardiovascular system.
Subcategory: Graphic recording.
Material studied: Recording of continuous EKG for 24 hours.
Estimated cost of test: $100.00 to $300.00.
Patient time for test: 24+ hours.
Reliability of test results: Good. Other tests, studies and clinical observations are necessary to establish a precise diagnosis.
Available as home self-test? No.
BEFORE THE TEST
Purpose of test:
Detects abnormal heart rhythms.
Evaluates chest pain.
Evaluates heart's status after myocardial infarction* or pacemaker implantation.
Evaluates effectiveness of anti-arrhythmic drug therapy.
Assesses and correlates labored breathing and central-nervous-system symptoms, such as faintness, lightheadedness and palpitations, with actual heart events and your activities.
Where is test performed?
Home and 24-hour environment.
Who performs test?
Lab technician, nurse, doctor.
Risks and precautions:
Electrodes should not be placed over large muscle masses, such as pectorals.
Patient preparation:
Activity--No changes necessary.
Diet--No changes necessary.
Medicines--No changes necessary.
Disrobing--Remove all clothing. Put on surgical gown.
THE TEST
Sensory factors:
Touching--Monitoring requires attachment of electrodes to your chest. In some cases, your chest is shaved. You may feel some discomfort when electrodes are attached to your chest.
Feeling--Some degree of apprehension or fear is normal and should be expected. Discomfort disappears when the test is finished.
Other senses (sight, smell, hearing, taste)--Not affected.
Equipment used:
Portable cassette recorder.
Chest electrodes.
Monitor and belt.
Patient diary.
Alcohol solution and cotton swabs.
Electrode paste.
Shaver.
Lead wires.
Description of test:
Test requires you to wear a small tape recorder for 24 hours. You are provided with a shoulder strap or special belt to carry the recorder, which weighs about 2 pounds.
Go to your doctor's office or lab to have the monitor attached.
Skin on the chest area is cleaned and abraded.
Electrodes are attached to your cleaned, abraded skin with paste.
A test is made to be sure the monitor is working correctly.
You dress and continue routine activities during the monitoring period. Wear loose-fitting clothing with a front-buttoning top during the test period.
Log all your activities, including walking, sleeping, urinating, emotional upsets, sexual activity, physical symptoms and medications.
Do not tamper with the monitor or disconnect the lead wires or electrodes.
If you must bathe, take a sponge bath; the equipment should not get wet.
Avoid magnets, metal detectors, high-voltage areas and electric blankets.
During the monitoring period, be sure the recorder is working properly. If the monitor light flashes, one of the electrodes may be loose. Depress the center of each one.
Notify the technician if an electrode comes off.
At the end of 24 hours, return to the office or lab to have the electrodes removed and to return the monitor.
AFTER THE TEST
Immediate post-test care:
None.
Activity after test:
Chest electrodes are removed, and sites where they were attached are cleaned.
Although ambulatory EKG correlates your symptoms and EKG changes, it does not always identify their cause. If initial monitoring is inconclusive, the test may be repeated.
Time before test results available: 7 to 10 days.
TEST RESULTS
Test values:
Test results are determined by study of EKG tracings.
Normal values:
Normal rhythm.
Normal rate.
No segmented changes in EKG graphic recording.
What ABNORMAL may indicate:
Electrical-conduction defects in the heart's rate and rhythm-controlling system.
Rhythm abnormalities.
Premature ventricular contractions.
Rapid heart rates.
Signs of inadequate blood supply to the heart muscle.
Slow heart rates.
Taking these drugs may affect test results:
None expected.
Other factors that may affect test results:
Failure to apply the electrodes correctly.
Failure to carefully record daily activities and symptoms.
Failure to maintain your normal routine.
*See Glossary.
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From Complete Guide to Medical Tests by H. Winter Griffith, M.D. Copyright by Fisher Books. Electronic rights by Medical Data Exchange.
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