The world's first electrocardiograph was created in the late 19th century by the English medical scientist Waller. His invention was a real breakthrough in the diagnosis of cardiovascular diseases . Since the beginning of the 20th century, this necessary tool has been continuously improved in the work of cardiologists, and nowadays no hospital can manage without it.
What does Holter monitoring show?
In the diagnosis of cardiovascular diseases, the ECG is of great importance. The only drawback of this method, which complicated the diagnosis of pathologies, was the inability to observe the work of the heart for a long time. He managed to eliminate the American Norman Holter in 1961, invented a portable cardiograph, which was named after the talented scientist.
The modern "Holter" is a small device, which allows to carry it on the body without any apparent inconvenience. Daily monitoring of the ECG by Holter is a continuous control of the heart muscle of a patient in a habitual setting for him. With his help, the doctor fixes the symptoms of the pathology and establishes its cause. This type of diagnosis is carried out in different ways:
- A detailed record of the heart rhythm of the patient for several days, which registers about 100 thousand heartbeats.
- With the help of a hypodermic implant, a large-scale registration is carried out for many months.
- An episodic assessment of the work of the heart during physical exertion on the body or pain in the chest. In this case, the device is operated by pressing the button by the patient himself.
Holter monitoring - interpretation
Decoding holterovskogo monitoring ECG performed a special computer program, installed in clinical decoders. The initial stage of electro-classification is performed by the device itself in the process of operation. All the data recorded by the device, the cardiologist enters into the computer, corrects and writes out the conclusion. After decoding and careful analysis of the monitoring results, the patient receives a detailed conclusion and referral for treatment, if necessary.
Description of monitoring results is carried out according to the following parameters:
- indicate the type and type of observation;
- the total frequency of contractions of the heart muscle over the entire observation period;
- describes the type of heartbeat: normal, rare or rapid;
- heart rate during exercise and at rest;
- there is an arrhythmia , if any, and other irregularities in the heart;
- the number of cases of tachycardia and their possible connection with physical or psychological stresses are recorded;
- changes in the final site of the ventricular complex;
- change of intervals PQ and QT.
Holter monitoring is the norm
A qualified specialist can correctly assess the normal function or detect a pathology of the myocardium. The diagnosis determines the state of the heart muscle, the sufficiency of its blood supply or the presence of oxygen starvation. The norm is the sinus rhythm of the myocardium and heart rate within 85 beats per minute. Daily cardiac rhythm monitoring is used for suspected ischemic heart disease.
Signs of this disease appear with a decrease in the conductivity of the coronary arteries. In this case, Holter registers depression in the ST segment. The ischemia index for Holter monitoring is a decrease in ST to 0.1 mV. Examination of a healthy heart will show another picture: the norm in the absence of IHD is considered to be the rise of this area to 1 mm.
Holter monitoring system
Many cardiovascular diseases in the initial stage do not cause specific symptoms. The patient can feel discomfort in the chest only during active life or at night. Failure of cardiac rhythm (arrhythmia), which is characterized by inconstancy, is very difficult to identify in the process of conducting an ordinary electrocardiogram in a clinic.
In such cases, Holter ECG monitoring system comes to the aid of cardiologists, which describes the work of the myocardium during the day. Modern machines differ from the first samples in small size and weight, which allows the patient to lead a habitual way of life. All the initial data have the ultimate accuracy and reliability, which significantly accelerates the elucidation of the cause of cardiac pathologies.
Electrode overlap in Holter monitoring
The mobile electrocardiogram is performed by the registrar, which records the heart rate readings using disposable electrodes. The device itself holterovskogo monitoring works on batteries and is located on the waist of the patient in a special case. Apparatus for continuous monitoring of cardiac muscle, depending on the model, takes from 2 to 12 independent ECG channels and is equipped with a cable with 5, 7 or 10 branches to which the electrodes are attached. They are fixed on the patient's chest using a patch in places with the least amount of adipose tissue.
During the survey, a special gel is supposed to help increase the electrical conductivity of the body surface. Skin areas and metal parts of the electrodes are pre-treated with a cleaning solution and degreased. All these manipulations are performed by qualified specialists in the polyclinic.
Holter monitoring of ECG and blood pressure
In a number of cases, the patient needs a double study. In addition to monitoring the function of the myocardium, the doctor has the ability to track the dynamics of the arterial pressure of the patient. Daily monitoring on the ECG Holter and BP is prescribed to confirm or deny the preliminary diagnosis, for example, in IHD.
Holter monitoring of ECG
ECG monitoring in Holter is a permanent graphical record of myocardial contractions, which is one of the two main diagnostic techniques for various diseases of the cardiovascular system. It is considered most effective in detecting arrhythmia and the latent form of myocardial ischemia. Very often, these diseases are accompanied by hypertension or hypotension.
Holter Pressure Monitoring
This method involves placing a cuff on the patient's shoulder that joins the device and measures blood pressure in parallel with the electrocardiogram. Sometimes the failure of the heart rate directly depends on the "jumps" of blood pressure at certain times of the day or as a result of physical or emotional stress. Monitoring of blood pressure on the holter helps to establish this relationship, to find and eliminate the cause of the pathology.
Holter monitoring - how to behave?
Patients who have been assigned daily Holter monitoring should correctly prepare for it. There is no particular complexity in such training. There are several important aspects to consider:
- Before starting the procedure, it is important to take a bath or wash in the shower, as the unit should not be exposed to water.
- On clothes and on the body there should be no metal products.
- It is important to warn the doctor about medications taken if they can not be canceled.
- It is necessary to give the expert results of the analyzes and other diagnostic methods.
- It is necessary to inform the medical staff about the presence of a pacemaker, if any.
- Do not focus on the device that you will be wearing during the day, as this can affect the results of the survey. Excessive emotion will not be of use. Try to spend this time as usual on ordinary business.
Holter monitoring - what can not be done?
Daily Holter ECG monitoring is a useful and necessary diagnostic method that requires the patient to adhere to certain rules:
- Do not use electrical appliances (toothbrush, razor, hair dryer, etc.).
- Stay at a sufficient distance from the microwave oven, metal detectors and magnets.
- X-rays, ultrasound, CT or MRI can not be performed during monitoring.
- At night, sleep on your back so that the device is not subjected to mechanical stress.
- Do not wear synthetic underwear or outerwear.
Holter Monitoring Diary
Holter's heart rate monitoring is not limited to wearing the device. During the procedure, the patient keeps a diary in which he notes:
- duration of the working day and occupation;
- time and type of rest;
- list of food products and beverages;
- work at home;
- physical exercise;
- emotional condition;
- duration and quality of sleep;
- taking medications with an indication of the exact time; this aspect is very important if Holter monitoring of blood pressure is carried out in parallel;
- presence of unpleasant or painful sensations in the region of the heart, dizziness, pre-patchy condition, headache, etc.
After the end of the examination, the device is removed from the patient. The data of the registrar and records from the diary are placed in the computer for processing, and then the cardiologist makes corrections and writes out the conclusion.