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HolterThe holter is an instrument that is used to record the electrical activity of the heart for several hours. Also called holter-ecg or holter monitor. The main advantage presenting this device is to make a record of your heart rate for a long time, since a routine electrocardiogram only allows us to know what is the cardiac electrical circuit at that time and we do not know whether before or after it was altered.
The name of this test is because Norman Holter, an American physicist from the beginning of the 20th century that focused his studies in the field of Biophysics. The development a monitor light, the size of a Briefcase, easily transportable and with the ability to write a continuous recording of the heart rate. Before this invention, electrocardiograms were occupying an exclusive hospital room and required much time and previous preparation. During the rest of the 20th century the holter has been improved, making it more lightweight and smaller, and with a digital record that facilitates their realization to the patient and the doctor.
This appliance only measure the activity of electrocardiography, heart and breathing ratecan be. It is not usual that blood pressure should be measured at the same time. At night, the holter can be complemented with other devices that measure the oxygen saturation in blood, among other parameters, as is done in polysomnography.
It is a test that is not excessive spending, but has a difficult to interpret, so must be carried out by experts and only when you go to be useful to determine a diagnosis or adjust a treatment. Can be performed on an outpatient basis, in a way that does not interrupt the daily routine of the patient too, you just have to pick up and deliver in the hospital or clinic usual holter. Today it is a test that is performed daily in many hospitals, even in children.
When doing a holterPerform a holter is useful when certain situations occur or are suspected the following diseases:
Fainting or syncope recurrence: Although an isolated fainting is not cause for concern, when they recur spontaneously and suspect that the cause is cardiac, a holter can help to find out what type of cardiac alterations there are basic.
Palpitations: sensation that the heart beats faster than normal, or printing note beats in the neck, can be signs of arrhythmias in people of a certain age. If it is an intermittent sense, a holter can identify alterations throughout day.
After a heart attack: depending on how the heart attack has been (extension, gravity, involvement of electrical pathways, etc.) can be indicated the realization of a holter to timely detect electrical alterations that may be fatal.
Study of arrhythmias: Although the cardiac arrhythmia is known, a holter study can help identify what triggers it, its duration and classify them in specific types (locks, supraventricular tachycardia, atrial fibrillation...).
Study of cardiomyopathies: cardiomyopathies are diseases of the own heart muscle infarction and arrhythmias independent reasons. However, they may be in themselves cause of arrhythmias and holter can identify them, even if they do not give symptoms.
Monitor treatment with drugs: many of cardiological drug treatments require verification of its effects on the electrical rhythm of the heart throughout the day.
Preparation for holterIf they are going to perform a holter these are the issues you should keep in mind to go well prepared for the test:
Duration: holter lasts almost always 24 hours. To perform throughout the day is not a waste of time very important the person who completes you, because you can take your life without alterations. The only extra time would be the collection and delivery of the device after the test.
Income: holter outpatients can be performed at home and you can make a normal during those hours life, although it is not recommended to an intense physical exercise after the completion of the test.
Is necessary to be accompanied?: is not necessary to be accompanied. During the day you can go back home or go to work directly.
Drugs: don't need to take any prior medication. You should tell your doctor all the medicines taken regularly and will decide which suspend or maintain, especially if you take drugs for epilepsy, psychiatric illnesses, antiarrhythmics, relaxing muscle or have received anesthesia the previous days for any reason.
Food: there is no why stay in fasting prior to testing or after. A light dinner is recommended to sleep at ease and avoid taking all day coffee, alcohol and other exciting substances, including also the day prior to the test.
Clothes: you can use the same clothes every day. That Yes, we recommend showering before placing the holter, since during the test you can not bathe or shower. During the 24 hours that last test you should avoid approaching electromagnetic areas and devices of that type: power stations, electric blankets, MRIs, blood pressure monitors, detectors of metals...
Documents: is essential to take with you the steering wheel which shows the performance of this test, as well as the card. Normally you will not you any document after the test because it takes time to analyze them.
Pregnancy and breast-feeding: holter is not contraindicated in pregnancy or lactation, although Yes it is you need to know if you are in that State because some biological constants that are studied will be altered from itself during these stages.
Contraindications: holter does not have any specific contraindication.
How is holterFirst, the doctor will assess if it may be useful to perform the holter in your home. Most of the times is a 24-hour holter, although there are special situations where you can indicate perform a holter for less or more hours.
One will quote you one day to pick up the device and they explain the basic measures that you need to know to put you to the test. The best thing is that you get to the hospital early, to arrive at time of pick up the device and perform a daily activity daily the rest of the day, since it is not necessary for you to change your habits the day of the test. Only be recommended not to take from the day before coffee, alcohol and beverages exciting. Avoid any stressful activity plan the day you go to perform the holter, even moderate sport (such as running or make bike). It is only intended to perform this type of exercise if symptoms studied appear during the same and are not serious symptoms.
At the Medical Center, will be placed you a series of sensors in the skin of the chest, which will lead into a small device that collects electric data. If you're allergic to the adhesive bandage or any substance used to set the sensors you must communicate this previously. Today there are hölters which are a simple tape that surrounds the chest, without any wires or loose sensors. After it you will see that all sensors work and properly capture the electrical measurements of the heart.
Once placed all sensors you can be a normal everyday life, without great effort or large excesses. The food should be light, it must ensure a good night's sleep and is recommended. Overnight does not you'll notice that carry the device. You'll sleep like you any night.
The next morning to attend to the medical centre and they will help you to remove all sensors with acetone, diluting the glue. Should you not stay to wait for results, as the doctor should carefully study your holter data. Some modern holter sent by computer the results of the study directly, even there are fixed hölters accompanied by simultaneous pacemaker.
Complications of holterThe holter is a completely safe test, which does not represent any risk for people who perform it. The only complication that is known of her is that some of the sensors that are stuck to the skin can irritate it in especially sensitive people, something not very common.
A holter can never alter the heart rate, since it is not able to emit electric shocks and the sensors are placed on the surface of the skin.
The only cases of complications related to the holter are due to a bad use of the same, especially when the patient who carries it decides to take a shower or bathe. In the end it is an electrical device which must not get wet.
The holter resultsThroughout the day the sensors capture the electrical activity of the heart and are stored in a digital record. At the same time that the test you can see these measurements if the holter is a model of high-tech, but it is virtually impossible to analyze them because it takes time and dedication to study all the components at the same time, moreover, is only useful in complex and serious heart disease patients.
The holter registration consists of the drawing of the electric pace. As in the electrocardiogram, a line appears with several waves and peaks that are a reflection of the electrical activity of the heart. There are three groups of waves that are repeated in every heartbeat: P wave (showing the contraction of the Atria), the QRS wave (which designates the contraction of the ventricle) and T-wave (where the heart relaxes and readies for another heartbeat). This path is drawn on a grid to help measure the duration of each wave and the distance between them.
You can go to pick up the medical specialist who sent you the test, holter results normally is a cardiologist. On that date it explain the alterations that have been throughout the study. Maybe that changes electrical rhythm that are related or not with the cardiac or respiratory frequency should be observed. As a result of the results the doctor will propose possible solutions. For example, an increase in heart rate may relate to a change in QRS waves and therefore I would point out a fault of the contraction of the ventricles. Following the results the doctor will propose possible solutions that can consist of medication or the realization of a catheterization.