What is Holter ECG monitoring named after the inventor of Holter's biophysics? This technique was a new step in the improvement of cardiology.
The availability of continuous monitoring of the work of the heart within a day or more has made adjustments to the notion of the normal rhythm of the organ and its violations.
Constant modification of the device opens new possibilities for recording the electrical processes of the myocardium. This allows you to accurately determine the localization, the degree of damage to the heart muscle and prescribe effective therapy.
Application and effectiveness of
The need for Holter monitoring was dictated by the frequent situations when the patient experienced
heart problems during the day at rest or after physical exertion of , any events, but a notestandard ECG, produced after a while, does not detect violations.The system of daily holter monitoring of ECG allows:
- To evaluate the functional activity of the myocardium, its rhythm and conductivity in a habitual way of life, emotional and physical activity.
- Evaluate the state of the heart at rest, during sleep.
- Determine the presence of heart rhythm disturbances, record their cyclic changes, the number of repetitive episodes during monitoring, duration, intensity, nature of ( ventricular, supraventricular) and the conditions of arrhythmia. It is important that the daily recording of extrasystoles( untimely heartbeats) reveals whether their number is within the norm or not.
- To reveal the form of angina pectoris( stable, unstable), including asymptomatic( painless) myocardial ischemia. The method determines the number and duration of episodes, as well as the conditions, the load threshold and the heart rate at which ischemia develops. In the presence of pain in the heart, the cause of their occurrence is identified( insufficiency of blood supply, osteochondrosis, neuralgia).
- Track the relationship between the subjective feelings of the patient and the objective indications of the device.
- Make an accurate diagnosis of , prescribe adequate treatment and monitor the effectiveness of medications taken by the patient.
- Evaluate the changes in the work of the heart in the presence of an electrocardiostimulator.
Difference from conventional electrocardiography and echocardiography
The methods of the standard ECG, ECHOCH and Holter monitoring were invented with the sole purpose of detecting pathologies in the work of the myocardium. However, significant differences in methods cause the expediency of their conduct in those or other cases.
Standard electrocardiography detects rhythm disturbances( tachyarrhythmia, bradyarrhythmia, atrial fibrillation), cardiac muscle( ischemic disease) and electrical impulses( blockade), but only at the time of the examination.
For example, an arrhythmia attack that occurred earlier will not appear on the ECG record an hour later. Also, pathologies that are not accompanied by electrical impulses( valvular defects of a small degree) are not fixed.
Holter monitoring in contrast to standard ECG is more reliable and informative method with a large number of analyzed parameters.
Heart activity is registered within 24 hours( if necessary, up to 7 days), therefore all non-permanent, transient disturbances are fixed on the device.
The undoubted advantage of the latest models of the Holter ECG monitoring device - , is the additional function of monitoring the daily blood pressure ( blood pressure).
Echocardiography significantly differs from these techniques. It allows the to see the heart on the ultrasound scanner screen and thus determine the size and thickness of the walls of the cardiac chambers, the blood flow rate, the presence of blood clots in the cavities, the degree of the atherosclerotic process, and also see the cardiac activity in real time.
Assigned as an initial examination or after detecting changes in the electrocardiogram.
Indications for monitoring
The long-term study of the data recorded by the Holter instrument made it possible to determine when the purpose of this method is appropriate. These are:
- Patient conditions presumably indicative of arrhythmia of ( dizziness of unexplained etiology, fainting, palpitations, heart failure).
- Identification of ECG changes, often complicated by arrhythmia ( myocardial infarction, prolonged QT syndrome).
- Conditions presumably indicative of ischemic disease( pain in the chest, shortness of breath, especially after physical exertion, psychoemotional spike), as well as diagnosing asymptomatic heart ischemia.
- Control of the effectiveness of therapy - medical and surgical treatment of arrhythmia and coronary heart disease. Changes are assessed after drug administration, ablation of the pathways, stenting and shunting of the coronary arteries.
- Monitoring the pacemaker.
- Monitoring of patients at risk of arrhythmia or coronary artery disease( with congenital and acquired cardiac pathologies after myocardial infarction).
- Arterial hypertension with signs of cardiovascular failure.
- Insufficiency of blood circulation of II-III degree, renal failure.
- Preparation for surgical intervention of on the heart and other organs in people with myocardial pathologies.
More on the technique and its advantages, see the video:
Holder's
Holter technology is a portable registrar weighing less than 0.3 kg , attached to the patient's body by a special belt. At certain points of the thoracic region after the skin is degreased with alcohol solution, electrodes are attached.
Recording is carried out on several channels( from 2 to 12), but the most is distributed 2 and 3-channel recorders .At the first examination, a 12-channel device is usually used, since it provides more information, with repeated monitoring of 3 channels.
For the duration of the study, the patient is given a diary , in which all activities, sleep time, medications taken, feelings, complaints, and well-being are marked by the hour.
recommends specific physical activity of ( climbing stairs, fast walking) in order to analyze the work of the heart during and after an increased load.
In other respects, the patient follows the habitual way of life of .After the time has elapsed, it is necessary to return to the clinic for removal of the device.
Features of the survey, how to prepare
No special preparation for the survey is required. The exception is men with a strongly puffy chest. To ensure a tight fit of the electrodes, the hair must be shaved off.
While monitoring , there are no restrictions in the habitual way of life and diet, but:
- can not take water procedures to avoid damage to the apparatus;
- , mechanical and thermal damage to the machine must not be allowed;
- must not be located near power lines;
- should not tolerate loads with increased sweating, as this can trigger the peeling off of the electrodes.
Decoding of the results
After the device is removed, the entry data is entered by the doctor into the computer - decoder .The digital system analyzes the data that is viewed and corrected by the doctor, then a conclusion is drawn on their basis.
The standard interpretation necessarily indicates information on heart rate, ventricular and supraventricular extrasystoles( rhythm disturbances), pauses in the rhythm, changes in PQ and QT intervals. The revealed pathologies are illustrated by printouts of the electrocardiogram for the monitoring period.
The decryption time takes about 2 hours .After getting acquainted with the results, the treating physician is prescribed the appropriate treatment.
The undeniable advantage of the method is the possibility of carrying out in the usual home conditions and without interrupting the work, studying .An easy and painless examination on the Holter device gives an objective picture of the heart, which facilitates the appointment of effective therapy.
