Holter monitoring of the heart: preparation as carried out, rules for the patient

From this article you will learn: what Holter monitoring is, to whom it is assigned, how it passes. Inspection rules, contraindications and side effects.

Contents of the article:

Contents for the
procedure Preparation for Holter monitoring
How Holter monitoring is performed
Maintaining the diary during the survey
Memorandum of rules for the patient
Data interpretation
Contraindications and side effects

Holter daily monitoring is a diagnostic electrocardiography procedure in whichrecord the electrical activity of the heart throughout the day using a portable device.

This diagnostic method is prescribed by a cardiac specialist: cardiologist or arrhythmologist.

Indications

conducted with no symptoms appoint

Holter ECG administered to a patient with these symptoms:

pain and a burning sensation in the chest;
heart palpitations;
dizziness;
shortness of breath;
syncope or pre-fainting condition.

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This procedure is especially popular when the patient is disturbed by unpleasant symptoms, and the usual electrocardiogram and ultrasound of the heart showed no deviations.

For accurate diagnosis of arrhythmia

This examination is prescribed to patients with suspicion of atrial( paroxysmal) tachyarrhythmias. They are almost impossible to diagnose with the usual ECG, as they appear in the form of seizures, and the patient can not come to diagnosis directly during one of them. Paroxysmal tachyarrhythmia may appear at such diseases:

congenital heart defects( WPW syndrome, LGL syndrome, cardiomyopathy);
suffered myocardial infarction or multiple microinfarctions;
angina;
myocardial ischemia.

Other types of arrhythmias can also be diagnosed, for example, extrasystole.

To monitor the effectiveness of treatment

Daily monitoring of heart activity is assigned to monitor the effectiveness of treatment( e.g., after ablation of additional conductive paths when WPW syndrome).

In addition, it is recommended Holter examination after the pacemaker is installed - to check if it works correctly.

Preparing for the

Survey No special training is required.

But we recommend that you take a shower shortly before the procedure, as during the examination this can not be done( electrodes and the device can not be wetted).

In addition, tell your doctor if you are taking any medications.

How Holter monitoring is performed

The procedure is very simple:

The patient undresses to the waist.
In the place of attachment of electrodes, shave off the hair and degrease the skin with alcohol.
Special disposable electrodes are attached to the body( similar to those used in conventional ECG).
To the electrodes wiring attached device on the battery, which registers the electrical activity of the heart for 24 hours and stores it on the built-in memory. It can be fastened to the body of the patient with a special belt or fixed in another way for the convenience of the subject( so you do not have to carry it in your hands or in your pocket).
With the device, the patient conducts his usual lifestyle. Sometimes the doctor may ask the patient to perform any exercise during Holter monitoring. This is necessary in order to evaluate the reaction of the heart to the load and its recovery after them. Also the doctor can ask to keep a diary in which the subject writes down what and what time he did during the day and when he went to bed.
In a day( this is the minimum period of the examination, sometimes the doctor can prescribe a longer ECG monitoring - up to 7 days), the patient comes to the clinic to remove the device.
At the end of the procedure, disposable electrodes are peeled off and discarded. And the specialist connects the device to the computer. Then he scans and decodes the received data.

What to write in the diary

If the doctor told you to keep a diary, you will need to record there the key points of your day. Be sure to record the time:

medication;
food intake;
sleep( both night and day, if there was one);
emotional stress, if it was;
different in the activity of actions( be sure to fix the exact moment of the change of different actions on the activity, the time of their change can be recorded approximately).

Action Categories:

Category	Examples
Passive rest and exercise with low physical activity	Watching TV, reading, handicraft, study, writing
Actions that may require emotional stress	Playing computer or gambling, driving
with light physical exertion	Walk in the park, morning gymnastics
Average physical activities	Raising on steps above 3 floors, easy jogging
Intensivee load	workout in the gym, jog for longer than 20 minutes. Warning! Be sure to ask the doctor if you can perform this kind of action during the daily monitoring of the ECG.In addition, take care not to peel off electrodes during exercises and damage the device to fix the data.

Be sure to record the time of change of activity of one category for actions of another category.

If you feel any unpleasant symptoms( dizziness, palpitations and others) during the study, be sure to list them in your diary and write down the time.

Rules for the patient

For the results of the daily monitoring of the electrical activity of the heart to be as accurate as possible, you must adhere to certain rules:

Wear tight-fitting clothing made from natural fabric. It is better not to wear loose clothes, since electrodes can peel off from the body in it. A synthetic fabric can electrify, which will distort the readings of the device. On clothes above the belt there should be no metal elements.
Do not overcool or overheat the appliance.
Do not allow water or other liquid to come into contact with it.
Do not place it on vibrating surfaces.
Do not stand near electrical equipment or transformer booths.
Do not use your laptop or mobile phone for more than 3 hours a day. Do not hold the gadget closer than 30 cm to the Holter ECG monitor. Do not go close to a working microwave oven.
Do not sit or lie on the device. Put it so that it does not crush during sleep.
Make sure that the electrodes do not come loose.
Do not undergo physiotherapy and do not X-ray during the examination.
Ask your doctor beforehand if you can exercise during the examination.

Decoded data

On the results sheet you will see the following indicators.

Indicator	Normal
Average heart rate in the afternoon	60-100 beats per minute
Average heart rate at night and during daytime sleep	41-81 bpm
Diurnal heart rate change schedule	Changed when activity changes
Number of suprascalular extrasystoles	960 supraventricular extrasystoles per day( up to 40 pieces per hour) Minor excess of norm( up to 1200 pieces per day) does not pose a threat to life and health
Number of ventricular extrasystoles	Absolute norm - 0 Admissible amount, not life and health threatening, - 200 pcs.per day
The duration of the intervals QT and PQ and the graph of their change.	Interval standard QT: 340-450 ms( 0.34-0.45 s) for women and 340-430 ms for men PQ - 120-200 ms

Please note! The norms indicated in the table are averaged and do not take into account the age and individual characteristics of the organism. About the norm for you personally, check with your doctor.