• At-Home Tests

     
     
     
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    Holter ReaderHave you ever made an appointment with your physician only to find that once you are in the office the problem you’ve been having has gone away? Sometimes a “snapshot” of your heart’s health at the moment you are in the office or hospital is not enough to demonstrate your symptoms. Your cardiologist may need information about how your heart is performing over time to make a diagnosis.

    In cases such as this, you may be sent home with one of several types of monitors to record data about your heart’s performance over a couple of days, a month, or sometimes longer. Your cardiologist or another medical specialist will interpret this data to see if it suggests a diagnosis that may need to be confirmed with additional testing.

    Holter SensorsThe list below contains common tests performed at home that are used to diagnose cardiovascular disease. In-office and in-hospital tests may be performed as well.

    At-home tests:

     


    Holter Monitor

    A Holter monitor is a device that records your heart’s rate and rhythm, usually over a period of 24 to 48 hours. The monitor is a small, box-shaped electronic device that is connected with wires (leads) to sticky patches (electrodes) that are placed on the skin of your chest. The monitor is attached to a strap that goes around your shoulder or waist to hold it close to your body.

    How Does It Work?

    A Holter monitor, like an electrocardiogram, reads your heart’s electrical activity. Your heart has an electrical system that functions like a natural pacemaker. Electrical signals travel through the chambers of the heart to cause it to beat. If the heart’s natural electrical system is not functioning correctly, an abnormal heartbeat (arrhythmia) may result. This may be the cause of symptoms of your heart racing, palpitations, or feeling faint.

    The electrodes on the Holter monitor detect the heart’s electrical activity and transmit this information through the leads to the monitor. The battery-operated monitor continuously records this data.

    Whenever you experience heart symptoms while wearing the monitor, you will write down the symptom, date and time, and what activity you were doing at that time. Your cardiologist will compare your symptom log against the data gathered by the monitor to see how your heart was responding when you performed certain activities.

    How Is It Performed?

    You will be fitted for a Holter monitor at your cardiologist’s office. Once you have been fitted, you will wear the monitor day and night for the amount of time indicated by your cardiologist. You will be asked to continue your regular activities and to log these activities and any symptoms.

    Before you go to your cardiologist’s office for the monitor fitting, you may wish to take a shower or bath. You will not be able to do so once you are wearing the monitor, which should not be removed during the period of the test and which can also be damaged by water. Some patients may need to have small portions of hair on their chest shaved to allow the electrodes to connect properly. A nurse will stick the electrodes to your skin. Once you are wearing the monitor, the electrodes and wires will be hidden by your clothing. You may be given instructions on how to replace the monitor’s batteries if necessary.

    After the testing period is over, you will return the Holter monitor to the cardiologist’s office and give your activity/symptom log to the cardiologist for review in conjunction with the monitor data.

    Is It Safe?

    Wearing a Holter monitor is safe. However, if you have an allergy to any adhesives, be sure to let the cardiologist and nurse know, as the electrodes are attached to the skin with adhesive.

    Questions to Ask Your Doctor About Holter Monitoring

    The following questions can help you talk to your physician about wearing a Holter monitor. Print out or write down these questions and take them with you to your appointment. Taking notes can help you remember your physician’s response when you get home.

    • What information will a Holter monitor provide about my heart health?
    • What information should I log while I am wearing the Holter monitor?
    • Will I need to replace batteries in the monitor?
    • When do I return the monitor?
    • What happens next if the data from the Holter monitor shows a potential problem with my heart’s rhythm?

    Please print this list of questions here. Take them with you to the doctor and share them with friends and loved ones when you are encouraging them to see their doctors.

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    Event Monitors

    An event monitor, or recorder, is a wearable device that records the electrical activity of your heart periodically for up to a month. While a Holter monitor gathers data about the heart’s activity continuously, an event monitor records data only when an “event” is occurring - that is, when you are experiencing symptoms.

    The monitor is a small electronic device that is connected with wires to sticky patches (electrodes) that are placed on the skin of your chest. The monitor is small enough to clip to your belt or keep in your pocket.

    How Does It Work?

    An event monitor, like an electrocardiogram reads your heart’s electrical activity. Your heart has an electrical system that functions like a natural pacemaker. Electrical signals travel through the chambers of the heart to cause it to beat. If the heart’s natural electrical system is not functioning correctly, an abnormal heartbeat (arrhythmia) may result. This dysfunction may be the cause of symptoms of your heart racing, palpitations, or feeling faint. The event monitor records the heart’s electrical activities when you are experiencing symptoms. An event monitor is a good diagnostic tool for people who may experience infrequent cardiac symptoms.

    How Is It Performed?

    You will be fitted with an event recorder at your cardiologist’s office and given instructions on how and when to transmit data from the recorder. When you are experiencing cardiac symptoms, you press a button on the device to begin recording data from the heart’s electrical activity. The electrodes on the event monitor detect the heart’s electrical activity and transmit this information through the leads to the monitor. Some event monitors are able to detect abnormal heart rhythms and begin recording automatically.

    You will be asked by your cardiologist to periodically call a phone number to transmit data from your event recorder.

    Is It Safe?

    Wearing an event monitor is safe. However, if you have an allergy to any adhesives, be sure to let the cardiologist and nurse know, as the electrodes are attached to the skin with adhesive.

    Questions to Ask Your Doctor About Event Monitoring

    The following questions can help you talk to your physician about wearing an event monitor. Print out or write down these questions and take them with you to your appointment. Taking notes can help you remember your physician’s response when you get home.

    • What information will an event monitor provide about my heart health?
    • What will I need to do to record and transmit data from the event monitor?
    • When do I return the event monitor?
    • What happens next if the data from the event monitor shows a potential problem with my heart’s rhythm?

    Please print this list of questions here. Take them with you to the doctor and share them with friends and loved ones when you are encouraging them to see their doctors.

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    Implantable loop recorder

    An implantable loop recorder is a medical device that is placed beneath the skin in the chest to record data about heart events over a long period of time - up to two years. This type of monitoring can help diagnose someone who has infrequent symptoms.

    How Does It Work?

    An implantable loop recorder, like a Holter monitor and event monitor, reads your heart’s electrical activity. Your heart has an electrical system that functions like a natural pacemaker. Electrical signals travel through the chambers of the heart to cause it to beat. If the heart’s natural electrical system is not functioning correctly, an abnormal heartbeat (arrhythmia) may result.

    The implantable loop recorder continuously monitors the electrical activity of the heart and automatically begins recording information when the heart’s patterns change. Alternately, you may be instructed by your physician to turn on the device’s recording function by using an external “activator,” a hand-held device that you hold over the site on your chest where the recorder has been implanted.

    How Is It Performed?

    An implantable loop recorder is inserted by an electrophysiologist, a physician who specializes in the heart’s electrical system. The procedure is performed in the hospital under local anesthesia. The device, which is about the size of a flattened AA battery, is implanted through an incision in the chest, which is closed with stitches after implantation of the device. You can typically return home and to normal activity the same day.

    Your physician will be able to view data from the recorder on a specialized computer. After a diagnosis has been made, or at the end of the device’s battery life, the recorder may be removed in a procedure very similar to the one used for insertion.

    Is It Safe?

    Receiving an implantable loop recorder is a very safe procedure. Rarely, patients may experience infection at the insertion site. However, an implantable loop recorder, unlike a pacemaker, does not have wires (leads) directly into the heart, so it does not present a risk of infection from that standpoint. Please note that you should not undergo a magnetic resonance imaging (MRI) test from another physician without first speaking with your electrophysiologist.

    Questions to Ask Your Doctor About Implantable Loop Recorders

    The following questions can help you talk to your physician about wearing an implantable loop recorder. Print out or write down these questions and take them with you to your appointment. Taking notes can help you remember your physician’s response when you get home.

    • What symptoms make me a good candidate for an implantable loop recorder?
    • What will the implantable loop recorder tell us about my heart health?
    • Will I need to use an activator to turn on my implantable loop recorder?
    • Do I need to have an empty stomach before the procedure to insert the recorder? Should I withhold any of my medications? Are there any medications that I will need to take?
    • Will I have limitations after the procedure to insert the recorder? Will I need to have someone who can drive me home?
    • When will the implantable loop recorder likely be removed?
    • What happens next if the data from the implantable loop recorder shows abnormal heart rhythms?

    Please print this list of questions here. Take them with you to the doctor and share them with friends and loved ones when you are encouraging them to see their doctors.

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