The Holter ECG for the diagnosis of arrhythmias or silent ischemia in Caracas
Holter monitor (often simply «Holter» or occasionally ambulatory electrocardiography device) is a portable device for continuously monitoring various electrical activity of the cardiovascular system for at least 24 hours. Often used in patients with suspected cardiac arrhythmia or to diagnose silent ischemia in several simultaneous channels (usually three), allowing better visualization of the events.
The Holter monitor is named after physicist Norman J. Holter from Helena (Montana, USA), who invented telemetric cardiac monitoring, in the early years of the decade of the fifties, in the University of California, Los Angeles, when he managed to capture the EEG brain waves of lab rats, by receiving radio frequency signals that collected emitters connected to the brain of these animals. Then the Doctor Holter turned his attention to the heart and the first system used was based on the same principle of radio frequency , appearing published its first clinical application by radio telemetry system in 1954 , in the Journal of the Canadian Medical Association.
This first system had two serious drawbacks; the fading of the image when the subject was away from the receiving monitor and even more limiting, the transmitter system that the subject had to carry, weighted about 40 kg , making it inapplicable to any cardiac patient. These drawbacks were overcome by a sense of Dr. Glasscock, whom connected the patient to a portable lightweight transistorized receiver, which recorded on magnetic tape the ECG signal, which could be analyzed once recording was finished.
After 60 years, these principles of dynamic electrocardiography designed and developed by Holter and contributors, remain virtually inalterable, but with the emergence of new, smaller and versatile recording equipment and ultrafast computerized interpretation. Modern technology has made it much easier for patents using the heart monitor.
Because the average heart beats 100,000 times a day, the information obtained is roughly equivalent to 3,000 electrocardiograms. The monitor records the frequency and heart rate at the time the patient feels chest pain or symptoms of arrhythmia. Reading this information allows the physician to determine the nature of the patient’s heart problem.
How to does the Holter:
The monitor has between 5 and 7 wires called «referrals «. The leads are connected to metal disks called «electrodes «, which are placed on the chest, connected to a Holter monitor (of a smaller size than a cell phone). These electrodes are very sensitive and can pick up the electrical impulses of the heart. The Holter monitor records the pulse, giving the doctor a record of the electrical activity of the heart for 24 hours.
After the time of registration, the device is connected to a computer where all data collected are downloaded, processed, and useful information on heart rate and rhythm disturbances possible is obtained.
When symptoms are sporadic conventional Holter has limited effectiveness because the registration period may not coincide with the time that particular symptom is manifested.
The patient:
The activity during those 24 hours must be absolutely normal, except you can wet the Holter monitor. The patient will receive a sheet with your data and the start time of the recording, where he recorded any incidents in receipt (palpitations, dizziness, chest pain, etc.).
It is very important that the person accurately record your symptoms and activities performed, so that the doctor can relate these findings to with the Holter monitor results. This will allow the specialist analyze electrocardiogram recording right on the time the trouble occurred.
Requirements for examination and recommendations: (Only for patients with written physician’s order).
- Request an appointment, take note of the date and time of placement ( Monday through Thursday , preferably 8:00 am).
- Assist exactly when you are instructed to place and remove the equipment, because it needs to be downloaded, processed and deleted to be used on other patients. You WILL NOT require medical consultation. The setting time is about 20 minutes.
- You can eat food, not need of fasting.
- You must bring the physician’s order.
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The patient should bathe (and shave its CHEST if they are furry) before putting the monitor because during monitoring can not take a shower until it is removed.
- Do not use creams, powders, oils, perfums, because this can damage the monitor.
- You must bring a preferably open loose comfortable clothing with buttons. Ladies should preferably wear a two-piece outfit with a loose top, as you will need to remove your top (women may keep their bra on). Your top will also need to be placed comfortably over the cuff that will be placed on your arm.
- Keep taking all medications as directed by your physician, especially antihypertensive.
- You can not bathe or swim, or perform exercises during Holter monitoring. It is important for the patient to continue with their daily activities everyday except swim and exercise.
- You cannot withdraw your monitor for absolutely nothing.
- You can request the completion of this test in our office (Monday-Thursday), with immediate availability, both for those patients seen by our practice and those with other treating physician.
The exam includes:
- Determination of ambulatory electrocardiogram during 24 hours.
- Interpretation of results.
- Detailed report of electrocardiogram (24 hours), statistical analysis of the results obtained in both active period and rest period graphic media trends and outcome data, delivered in 24 working
hours report receipt back of the computer. - Payment is accepted by credit and debit cards (Visa, MasterCard and Maestro)