Daily Holter ECG monitoring: what it is, decryption

Monitoring (and not only in medicine) means the registration and preservation of certain changes in the time values, analysis and interpretation. In this sense, meteorological observations and seismic stations are also options for monitoring natural processes. In medicine «by Holter monitoring» is not that other, as a long ECG recording for 24 hours. What are the possibilities of this modification ECG records and what it is used?

Holter ECG monitoring is sometimes colloquially referred to as simply «Holter», after the famous American Biophysics, Professor Norman Holter who invented this method. He first appeared in 1961, and the Registrar is placed on the patient’s back and weighed about 40 kg, as semiconductor transistors at that time were not yet invented, and there was a technical revolution which changed the vacuum tubes to the transistors.

Currently, most Russian health care institutions written to tape in a small tape recorder odnoosnom weighing about 500 g, and the current Registrar are full-fledged microcomputer with touch screens and primary analysis of the recording. Some models allow the detection of critical indicators to independently contact the emergency services. In the absence of patient response, the Registrar causes the cardiology team at the location of the device, according to satellite navigation.

Of course, the most important daily monitoring is not acquired for the diagnosis of myocardial infarction and not for the assessment of hypertrophy. This is evident in the study of at least a few heartbeats on all leads.
This method was invented to catch the arrhythmias, in which there is no «guard» in the hospital. Because the arrhythmia can happen anywhere, anytime, even during sleep, and link the patient to the couch is absolutely impossible.

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The second reason for the emergence hmm ECG (even so, reduce the title of this study) was the desire to explore the function of the heart during exercise, for example, when conducting veloergometry in the free state, in various sports, as well as in aviation and space medicine.

How goes the research?

The entry for halter – what is it? It is not that other, as the registration is simplified the number of leads. Normally, when an ECG recorded three standard, three reinforced and five chest leads. A total of 11 different charts, showing the heart «from different angles». As the twentieth century was not the miniature computer technology, the Registrar usually has been recording 2 or 3 channels. This is quite enough for most medical purposes, the leading one was the study of arrhythmias and diagnosis of acute attacks of myocardial ischemia.
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First of all, pre-podgotavlivaya the patient’s skin. To do this, carefully shaved all the vegetation, the skin is degreased and thoroughly cleaned with abrasive paste below slumit the top, dead layer of epidermis, which can serve as an insulator. Next to the skin firmly glued disposable electrodes. They connect wires with the Registrar, which is usually attached to the patient’s belt or worn in a pocket.

After a while the patient gets used to the electrodes and the wires, and he needs only one thing – to live a normal life. With each change in their physical activity and emergence of unpleasant feelings, and especially any pain the patient must accurately (preferably to the second) to record in the diary, which is submitted after the end of the study. It is desirable to measure blood pressure as the comparison of AD and ECG can explain a lot specialist.

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Interpretation of results

The interpretation of results is engaged in the doctor of functional diagnostics. When the decoding of the useful signal, in the case of the appearance of signs of oxygen starvation (ischemia) of the myocardium according to the Holter data is compared with the entry in the «logbook», which was provided by the patient. This allows you to make very important conclusions and even reveal specifics of the diagnosis. For example, if the halter shows episode of myocardial ischemia and 5 minutes before that, the patient noted that he had gone to cut firewood, we can conclude that he has angina. But if an episode of ischemia appeared among the rest or an afternoon NAP, it is a more serious symptom of the development of angina at rest, and requires serious examination.

In conclusion, I must say that Holter monitoring is a «screening» method, and his love for the breadth of coverage. If a day or even two or three days not recorded no violations of rhythm, this does not mean that the arrhythmia will not occur for, say, a week. It should be clearly understood. Therefore, this study is very suitable for healthy patients who are undergoing preliminary or periodical medical examination, and also arranged in the superstructure or the service contract, which requires attention to the health of employees.

Often the question arises: «how to cheat» halter and make sure to show a healthy record? The answer is: nothing. You can fool the doctor, but the Registrar shows reliable information about the condition of the heart at the time of the survey. So you should try before the examination not to worry, not to drink alcohol or smoke, sleep well and during the survey period spend time comfortably and quietly, away from computer, TV and other sources of negative information, causing the release of adrenaline and heart palpitations.

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