Holter monitoring is a method of instrumental diagnostics of the heart, proposed by the American biophysicist Norman Holter. A portable device is attached to the patient's body for 24 or 48 hours. During this time, the Holter monitor reads the necessary information using electrodes, forms an electrocardiogram at different periods of human activity. The main advantage of the method is extensive diagnostics, which captures the state of the heart during rest, household or non-standard physical exertion.
What do you need to know about the method?
24-hour Holter monitoring helps to record the patient's electrocardiogram over a long period of time. So the medical employee will receive a more accurate and expanded amount of information about the state of the heart. The essence of the study is the continuous recording of the electric field that the organ generates using a recorder or registrar. This is a special portable device that the patient must carry with him during the examination. It can be attached to a belt or fixed on a pocket to avoid serious inconvenience.
Some conditions that only appear under specific conditions (eg, stress, sleep, sports) can only be tracked through a 24-hour ECG Holter.
From 2 to 12 channels with electrodes are connected to the recorder, which record the electrocardiogram. The electrodes are attached to the human body, so water procedures, baths / saunas and other places that may affect the integrity of the device will have to be abandoned. Registrars can record the entire amount of information or record only specific fragments (events) of the functionality of the heart. The ECG can be stored both on magnetic tape and in the electronic memory of the recorder itself.
Brief historical background
Holter introduced a new diagnostic method in 1961. Over the next few years, it was improved and introduced into widespread medical practice. The 40-kilogram weighty registrar was replaced by a miniature 2-kilogram one. The weight of modern devices is about 500 grams. But the changes affected not only external characteristics. Physical activity has ceased to affect the quality of the recording, a function of automatic analysis and registration of several leads has appeared (the ability to examine the heart from different angles). Modern monitoring allows you to analyze not only the heart rate, but also the cyclic work of the organ, various temporal/spectral parameters that can seriously affect the course of therapy.
Holter monitoring has managed to change the understanding of the norms and pathologies of cardiac activity. So we learned that every person, regardless of the state of health, can be traced to changes in the rhythm. These changes cannot be attributed to pathological. On the contrary, it is a normal reaction of the body to various stimuli from the outside world or specific internal features.
Indications/contraindications for use
Holter monitoring is one of the most popular methods for diagnosing heart rhythm. He has only one contraindication - acute inflammatory processes on the skin. But even this contraindication can be eliminated with the help of specific therapy. In general, the diagnosis is completely safe and cannot harm the patient.
- complaints of interruptions in the work of the heart, increased heart rate, fainting without a pronounced etiology;
- monitoring the functionality of the pacemaker;
- suspected asymptomatic myocardial ischemia or sleep apnea syndrome;
- detection of rare but clinically significant conditions (diagnosis can take years);
- health monitoring after myocardial infarction and other heart pathologies.
Some clinicians recommend regular Holter monitoring if overweight.
Order of the study
Before starting monitoring, the patient must undergo an initial examination by a doctor who will determine the indications / contraindications for the study. If there is a need for it, the patient is given a registrar, they explain the essence of the procedure and are asked to adhere to the necessary safety rules.
For the next 24 (or more) hours, the patient is given a recorder and disposable adhesive electrodes. To attach the apparatus to the body, the hairline is shaved off, the skin is disinfected and slightly scarified. Scarification - damage to the epithelium using a special abrasive paste to improve the attachment and conductivity of the electrodes. Additionally, the skin is wiped with alcohol, dried, and only after that the electrodes are glued.
After turning on the machine, the patient is asked to calmly go about their usual activities, without making adjustments to the schedule. The only caveat is that water procedures will have to be abandoned for the duration of the study. A person goes to work, home, for a walk, eats, sleeps, sits in social networks, fixing his condition in a special diary.
If the patient feels pain, dizziness, tingling in the heart or other unpleasant symptoms, then records this in a diary, indicating the time and possible cause of discomfort. In some cases, doctors give the patient special tasks. For example, sit down several times, go for a long walk, and so on. So the specialist will be able to analyze the work of the body in stressful situations.
The order of examination may vary for each individual patient. The necessary information should be clarified with your doctor.
Decryption of results
The received results are processed in the decoder. A decoder is a standard computer with specific software. Some modern registrars carry out the primary classification of the recorded ECG, which greatly simplifies further decoding. It is important to understand that the results of automatic analysis may not be perfect. To minimize the risk of an erroneous diagnosis, any Holter record is additionally reviewed and corrected by a doctor.
What indicators can be tracked using Holter monitoring? First of all, this is information about the heart rate, its source, and also the frequency. The device captures any deviations from the norm, indicates their number, morphology and features, on the basis of which therapy is compiled. Also, the device captures rhythm pauses, intraventricular conduction and can track the work of artificial heart structures, if they are installed. The processed information is converted into illustrated cardiogram printouts. They show the functionality of the organ at specific time intervals.
The computer system and the attending physician are responsible for deciphering the analyzes. Together with the ECG, the patient is given medical documentation, which indicates the diagnosis, necessary therapy and preventive measures. Enjoy the benefits of modern medicine and be healthy.