Cardiac Center of Texas, P.A. Powered by ZocDoc Doctor Directory

Contact Us

Cardiac Center of Texas
Vein Clinic of Texas

4201 Medical Center Drive
Suite 380
McKinney, TX 75069

1600 Coit Road
Suite 209
Plano, TX 75075

(p) 972-529-6939
(f) 972-529-6935

Office Hours

Mon - Fri 8:00 a.m. - 5 p.m. CST

Memberships & Accreditation

Meet Dr. Khan

Holter and Event Monitors For Arrhythmias

What Are Holter and Event Monitors?

Holter and event monitors are medical devices that record the heart’s electrical activity. Doctors most often use these monitors to diagnose arrhythmias (ah-RITH-me-ahs).

Arrhythmias are problems with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm.

Holter and event monitors also are used to detect silent myocardial ischemia (is-KE-me-ah). In this condition, not enough oxygen-rich blood reaches the heart muscle. “Silent” means that no symptoms occur.

The monitors also can check whether treatments for an arrhythmia or silent myocardial ischemia are working.

Overview

Holter and event monitors are similar to an EKG (electrocardiogram). An EKG is a simple test that detects and records the heart’s electrical activity. It’s a common
test for diagnosing heart rhythm problems.

However, a standard EKG only records the heartbeat for a few seconds. It won’t detect heart rhythm problems that don’t occur during the test.

Holter and event monitors are small, portable devices. You can wear one while you do your normal daily activities. This allows the monitor to record your heart for a longer time than an EKG.

Some people have heart rhythm problems that occur only during certain activities, such as sleeping or physical exertion. Using a Holter or event monitor increases the chance of recording these problems.

Although similar, Holter and event monitors aren’t the same. A Holter monitor records your heart’s electrical activity the entire time you’re wearing it. An event monitor records your heart’s electrical activity only at certain times while you’re wearing it.

Who Needs a Holter or Event Monitor?

Your doctor may recommend a Holter or event monitor if he or she thinks you have an arrhythmia. An arrhythmia is a problem with the rate or rhythm of the heartbeat.

Holter and event monitors most often are used to detect arrhythmias in people who have:

  • Issues with fainting or feeling dizzy. A monitor might be used if causes other than a heart rhythm problem have been ruled out.
  • Palpitations (pal-pih-TA-shuns) that recur with no known cause. Palpitations are feelings that your heart is skipping a beat, fluttering, or beating too hard or fast. You may have these feelings in your chest, throat, or neck.

People who are being treated for heart rhythm problems also may need to use Holter or event monitors. The monitors can show how well their treatments are working.

Heart rhythm problems may occur only during certain activities, such sleeping or physical exertion. Holter and event monitors record your heart rhythm while you do your normal daily routine. This allows your doctor to see how your heart responds to various activities.

What To Expect Before Using a Holter or Event Monitor

Your doctor will do a physical exam before giving you a Holter or event monitor. He or she may:

  • Check your pulse to find out how fast your heart is beating (your heart rate) and whether your heart rhythm is steady or irregular.
  • Measure your blood pressure.
  • Check for swelling in your legs or feet. Swelling could be a sign of an enlarged heart or heart failure, which may cause an arrhythmia. An arrhythmia is a problem with the rate or rhythm of the heartbeat.
  • Look for signs of other diseases that might cause heart rhythm problems, such as thyroid disease.

You may have an EKG (electrocardiogram) test before your doctor sends you home with a Holter or event monitor.

An EKG is a simple test that records your heart’s electrical activity for a few seconds. The test shows how fast your heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through your heart.

A standard EKG won’t detect heart rhythm problems that don’t happen during the test. For this reason, your doctor may give you a Holter or event monitor. These monitors are portable. You can wear one while doing your normal daily activities. This increases the chance of recording symptoms that only occur once in a while.

Your doctor will explain how to wear and use the Holter or event monitor. Usually, you’ll leave the office wearing it.

Each type of monitor is slightly different, but most have sensors (called electrodes) that attach to the skin on your chest using sticky patches. The sensors need good contact with your skin. Poor contact can cause poor results.

Oil, too much sweat, and hair can keep the patches from sticking to your skin. You may need to shave the area on your chest where your doctor will attach the patches. If you have to replace the patches, you’ll need to clean the area with a special prep pad that the doctor will provide.

You may need to use a small amount of special paste or gel to help the patches stick to your skin. Some patches come with paste or gel on them.

What To Expect While Using a Holter or Event Monitor

Your experience while using a Holter or event monitor depends on the type of monitor you have. However, most monitors have some factors in common.

Recording the Heart’s Electrical Activity

All monitors record the heart’s electrical activity. Thus, maintaining a clear signal between the sensors (electrodes) and the recording device is important.

In most cases, the sensors are attached to your chest using sticky patches. Wires connect the sensors to the monitor. You usually can clip the monitor to your belt or carry it in your pocket. (Postevent recorders and implantable loop recorders don’t have chest sensors.)

The monitor is clipped to the patient’s belt and electrodes are attached to his chest and records an electrocardiogram strip which maps the data from the Holter or event monitor.

A good stick between the patches and your skin helps provide a clear signal. Poor contact leads to a poor recording that’s hard for your doctor to read.

Oil, too much sweat, and hair can keep the patches from sticking to your skin. You may need to shave the area where your doctor will attach the patches. If you have to replace the patches, you’ll need to clean the area with a special prep pad that your doctor will provide.

You may need to use a small amount of special paste or gel to help the patches stick to your skin. Some patches come with paste or gel on them.

Too much movement can pull the patches away from your skin or create “noise” on the EKG (electrocardiogram) strip. An EKG strip is a graph showing the pattern of the heartbeat. Noise looks like a lot of jagged lines; it makes it hard for your doctor to see the real rhythm of your heart.

When you have a symptom, stop what you’re doing. This will ensure that the recording shows your heart’s activity rather than your movement.

Your doctor will tell you whether you need to adjust your activity level during the testing period. If you exercise, choose a cool location to avoid sweating too much. This will help the patches stay sticky.

Other everyday items also can disrupt the signal between the sensors and the monitor. These items include magnets; metal detectors; microwave ovens; and electric blankets, toothbrushes, and razors. Avoid using these items. Also avoid areas with high voltage.

Cell phones and MP3 players (such as iPods) may interfere with the signal between the sensors and the monitor if they’re too close to the monitor. When using any electronic device, try to keep it at least 6 inches away from the monitor.

Keeping a Diary

While using a Holter or event monitor, your doctor will advise you to keep a diary of your symptoms and activities. Write down what type of symptoms you’re having, when they occur, and what you were doing at the time.

The most common symptoms of heart rhythm problems
include:

  • Fainting or feeling dizzy.
  • Palpitations. These are feelings that your heart is skipping a beat, fluttering, or beating too hard or fast. You may have these feelings in your chest, throat, or neck.

Make sure to note the time that symptoms occur because your doctor will match the data with the information in your diary. This allows your doctor to see whether certain activities trigger changes in your heart rate and rhythm.

Also, include details in your diary about when you take any medicine or if you feel stress at certain times during the testing period.

What Does a Holter or Event Monitor Show?

A Holter or event monitor may show what’s causing symptoms of an arrhythmia. An arrhythmia is a problem with the rate or rhythm of the heartbeat.

A Holter or event monitor also can show whether a heart rhythm problem is harmless or requires treatment. The monitor might alert your doctor to medical conditions that can result in heart failure, stroke, or sudden cardiac arrest.

If the symptoms of a heart rhythm problem occur often, a Holter or event monitor has a good chance of recording them. You may not have symptoms while using a monitor. Even so, your doctor can learn more about your heart rhythm from the test results.

Sometimes Holter and event monitors can’t help doctors diagnose heart rhythm problems. If this happens, talk with your doctor about other steps you can take.

One option might be to try a different type of monitor. Wireless Holter monitors and implantable loop recorders have longer recording periods. This may allow your doctor to get the data he or she needs to make a diagnosis.

What Are the Risks of Using a Holter or Event Monitor?

The sticky patches used to attach the sensors (electrodes) to your chest have a small risk of skin irritation. You also may have an allergic reaction to the paste or gel that’s sometimes used to attach the patches. The irritation will go away once the patches are removed.

If you’re using an implantable loop recorder, you may get an infection or have pain where the device is placed under the skin. Your doctor can prescribe medicine to treat these problems.

For further information please contact Cardiac Center of Texas at 972-529-6939 or send us a question through the patient portal under the For Patients tab at the top of the page.  Thank you for visiting CardiacCenterOfTexas.com.