Holter monitoring is a method of instrumental heart diagnostics 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, generates an electrocardiogram at different periods of human activity. The main advantage of the method is extensive diagnostics, which fixes the state of the heart during rest, domestic or non-standard physical activities.
What you need to know about the method?
Daily Holter monitoring helps to record the patient's electrocardiogram for a long time. So the medical officer will get a more accurate and expanded amount of information about the state of the heart. The essence of the study lies in the continuous recording of the electric field generated by the organ using a recorder or recorder. This is a special portable device that the patient must carry with them during the study. It can be attached to a belt or fixed on a pocket to avoid serious inconvenience.
Some diseases that manifest themselves only in specific conditions (for example, stress, sleep, exercise) can be tracked exclusively through the holter daily ECG.
Connect from 2 to 12 channels with electrodes to the recorder, which record the electrocardiogram. The electrodes are attached to the human body, so water procedures, visits to the bath / sauna and other places that may affect the integrity of the device will have to be abandoned. Recorders 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 a 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, its improvement and introduction into widespread medical practice took place. The 40-pound weighty registrar was replaced by a miniature 2-pound. The weight of modern devices is about 500 grams. But the changes affected not only the external characteristics. Physical activity ceased to influence the quality of the recording, the function of automatic analysis and registration of several leads appeared (an opportunity to examine the heart from different sides). Modern monitoring allows us to analyze not only the heart rate, but also the cyclical functioning of the organ, various temporal / spectral parameters that can seriously affect the course of therapy.
Holter monitoring has managed to change the concept of the norms and pathologies of cardiac activity. So we learned that every person, regardless of health status, can be traced changes in rhythm. These changes can not be attributed to the pathological. On the contrary, it is a normal reaction of the body to various pathogens from the outside world or specific internal features.
Indications / Contraindications
Holter monitoring is one of the most popular methods of heart rhythm diagnostics. 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 can not harm the patient.
- complaints of interruptions in the work of the heart, increased heartbeat, fainting without a pronounced etiology;
- control of the functionality of the pacemaker;
- suspected asymptomatic myocardial ischemia or sleep apnea syndrome;
- detection of rare, but clinically significant conditions (diagnostics can be carried out for years);
- monitoring of health after myocardial infarction, other cardiac pathologies.
Some doctors recommend regular Holter monitoring for overweight.
Before starting the monitoring, the patient must undergo a primary examination by a doctor, who will determine the indications / contraindications for the study. If there is a need for it, the patient is issued a registrar, the essence of the procedure is explained, and they are asked to adhere to the necessary safety rules.
For the next 24 (or more) hours, the patient is given a recorder and disposable sticky electrodes. To attach the device to the body, hair is shaved off, it is disinfected and the skin is 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 rubbed with alcohol, dried and only after that stick the electrodes.
After switching on the device, the patient is asked to quietly do the usual things without making adjustments to the schedule. The only caveat - 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 on social networks, fixing his fortune in a special diary.
If the patient feels pain, dizziness, tingling in the heart or other unpleasant symptoms, then fix it in the diary, indicating the time and the possible cause of discomfort. In some cases, doctors give the patient special tasks. For example, sit down a few times, go for a long walk and so on. So a specialist will be able to analyze the body's work in stressful situations.
The order of the study may vary for each individual patient. Necessary information should be clarified with your doctor.
The results obtained are processed in the decoder. A decoder is a standard computer with specific software. Some modern recorders conduct a 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 erroneous diagnosis, any Holter record is additionally reviewed and corrected by the doctor.
What kind of indicators can be monitored using Holter monitoring? First of all, it is information about the heart rhythm, its source, as well as frequency. The device records any deviations from the norm, indicates their number, morphology and peculiarities, on the basis of which the therapy is made. The device also captures rhythm pauses, intraventricular conduction and can track the work of artificial cardiac structures, if they are installed. The processed information is transformed into illustrated cardiogram printouts. They show the functionality of the body in specific time intervals.
Decryption of analyzes involved in a computer system and directly attending physician. Together with the ECG, the patient is issued medical documentation, which indicates the diagnosis, necessary therapy and preventive measures. Use the benefits of modern medicine and be healthy.