Ambulatory Electrocardiogram

Cardiac Event Monitoring, Electrocardiography, Ambulatory, Holter Monitoring

What To Think About

• Many people have irregular heartbeats from time to time. What this means depends on the type of pattern these heartbeats produce, how often they occur, how long they last, and whether they occur at the same time you have symptoms. Irregular heartbeats that occur at the same time you have other symptoms, such as dizziness or chest pain, may mean that the irregular heartbeats are causing your symptoms.
• Because a standard 12-lead electrocardiogram (EKG) is safe, inexpensive, and provides valuable information, your doctor will try it first before using an ambulatory monitor to test your heart function. A continuous recorder generally has 5 leads and provides less complete information than a 12-lead EKG. But a continuous recorder is more effective than a standard EKG for evaluating heart symptoms that occur intermittently. For more information, see the medical test Electrocardiogram.
• If your ambulatory EKG monitoring does not help find what is causing your symptoms, the test may need to be repeated or other heart tests may be needed to diagnose your heart problem accurately. For more information, see the medical tests Exercise Electrocardiogram, Cardiac Catheterization, Echocardiogram, Cardiac Blood Pool Scan, and Cardiac Perfusion Scan.
• Ambulatory heart monitoring is most effective when you are able and willing to carefully follow instructions throughout the monitoring period.
• If your heart symptoms occur less frequently than once in a 24-hour period, you may need an intermittent recorder instead of a continuous recorder.
• The continuous recorder and the loop recorder work best for people who pass out when they have symptoms of a heart problem. The loop recorder is not useful if you lose consciousness for more than a few minutes or if you are so confused when you wake up that you are unable to start the recorder.
• The event monitor records heart signals only when you are holding it against your chest.
• Intermittent recorders are better than continuous recorders for recording heart problems that do not occur very often.
• An implantable form of the loop recorder can be worn for several weeks and may be a good choice for people who have symptoms that occur rarely, such as once every 6 months. A small EKG monitor is surgically placed under the skin of the chest. The person uses a hand-held device to start the monitor when symptoms occur.

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Author:	Douglas Dana Robin Parks, MS	Last Updated: February 21, 2008
Medical Review:	Anne C. Poinier, MD - Internal Medicine E. Gregory Thompson, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
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