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Ambulatory monitors
Ambulatory monitors are small, portable electrocardiograph machines that record the heart's rhythm. Each type has unique features related to length of recording time and ability to send recordings over the phone. The various types include a Holter monitor, loop monitor, and transtelephonic transmitter.
Your doctor uses ambulatory monitors to:
- Assess your heart rhythm over time
- Correlate your symptoms with your heart rhythm
- Diagnose abnormal heart rhythms: what kind they are, how long they last, and what may cause them
- Guide treatment for abnormal heart rhythms
Holter monitor (also called ambulatory EKG): This device is a portable EKG recorder that you wear during your normal daily activities, including sleeping. It can be worn for one to three days.
Small sticky electrode patches are placed on the skin of your chest. Wires are attached from the electrodes to a box about the size of a portable tape player that is worn on a belt or shoulder strap. The monitor continuously records and stores the heart's electrical impulses.
While wearing the monitor, you will be asked to keep a diary of your activities and symptoms, such as fluttering feelings in your chest (palpitations), rapid heartbeats, and episodes of dizziness or faintness. Keeping track of the activities you were doing when your symptoms occurred is important, so your doctor can see what kinds of events are bringing on your symptoms.
When you complete your Holter monitor test, a technician will play the tape on a computer that analyzes the recording and detects the appearance of any rhythmic abnormalities. The technician prepares a report with a printout of any abnormal heart rhythms for the doctor to study.
Loop recorder (event recorder): This device is worn 24 hours a day except when showering or bathing. This monitor is worn for about a month and is used for patients who have less frequent arrhythmia episodes and symptoms.
The technologist attaches small electrodes to your chest and attaches wires from the electrodes to a box about the size of a portable tape player. Like the Holter, the loop recorder can hook to your belt or shoulder strap.
Whenever you feel symptoms, you depress a button. The monitor stores its recording of the event for the 60 seconds before your pushing the button and up to 40 seconds after the event is over. The loop recorder can store up to three events.
The recording of the rhythm can be transmitted later over the phone lines. The technician will give the recordings to your doctor for review. If the reading indicates an emergency, the technician will instruct you to go to an emergency room.
Transtelephonic transmitters: This device is not worn continuously. It is used only during the period when data picked up by the device are transmitted over the phone for evaluation by a physician. In the past, this type of transmitter was used for monitoring pacemaker function. However, now it also is used for patients with arrhythmias. It is particularly useful for evaluating symptoms that occur rarely, so usually are not evident during an office visit.
When you develop symptoms, a strip of your current heart rhythm can be transmitted to your doctor's office over the phone using a monitor with two bracelets or by placing the monitor against your chest wall.
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