Symptoms, Abnormalities and 24 Hour Holter Results
A 24-hour Holter monitor records continuous ECG during day and night away from the clinical environment while normal daily activities are pursued. Therefore, a 24-hour Holter monitor provides information above and over conventional standard ECG monitors. When the patient feels dizziness, faintness, racing heart, skipped beats, chest pain, shortness of breath, palpitations, fatigue or weakness, investigating the cause of these symptoms by recording beat-by-beat ECG will be necessary. A 24-hour Holter monitor is the best tool to discover the backgrounds of cardiac abnormalities.
What conditions can be diagnosed with a 24-hour Holter Monitor?
- Transient, abnormal (fast and slow, irregular) heartbeats
- The cause of unexplained syncopes (faintness), dizziness and palpitations
- The cause of chest pain of patients who cannot exercise
- Heart condition after a myocardial infarction
- Adverse effects on the heart from other diseases (high blood pressure)
24-Hour Holter Monitor Results
Heart problems, such as insufficient, excessed heart frequency, uncoordinated pump function or any damage in the heart muscle are reflected in ECG signals. A normal ECG is composed of a P wave, a QRS complex and a T wave; all represent the heart condition in active (depolarization) or resting (repolarization) state.
Insufficient Heart Frequency
Insufficient heart frequency means abnormally slow heart rhythm, which may result in bradycardia or pause. In case of bradycardia, the resting heart rate is under 60 beats per minute in adult medicine. Possible symptoms are fatigue, dizziness, weakness. In case of pause, the heart stops temporarily. Both conditions hinder sufficient blood and oxygen supply.
Excessed Heart Frequency
Excessed heart frequency or tachycardia results in a fast heart rate, which does not allow enough time for the heart to fill before it contracts, so normal blood flow is compromised.
Uncoordinated Pump Functionheart problems
The wrong sequence of electrical impulse flows and uncoordinated contraction of the heart muscle requires prompt interventions.
Heart Muscle Damage
Blockage or damaged or even dead heart cells may be the result of myocardial infarction (heart attack).
On the basis of recorded ECG, 24 hour Holter monitor results will show whether the patient suffers from any cardiac abnormalities.
Risks of Cardiac Abnormalities
On the basis of the recorded ECG, the medical professional will know whether the patient has any chances of developing serious cardiovascular irregularities.
Heart Rate Variability
Heart rate variability (HRV) describes the variations between consecutive heartbeats. No variations between R-R intervals indicate high inflexibility meaning that the heart cannot adjust to changing environment. Abnormal changes in R-R cycles indicate arrhythmias.
ST-segment abnormalities include ST elevation or ST depression, something which a 24-hour Holter monitor can clearly indicate. ST-elevation signals myocardial injury, while ST depression indicates myocardial ischemia, which can worsen to injury (heart attack). Ischemia means lack of oxygen supply to tissues.
Heart Rate Turbulence
Heart rate turbulence (HRT) means a short acceleration followed by a deceleration of the heart rate. HRT gives information on the risk of sudden cardiac death.
Long or Short QT
A shortened QT interval may indicate elevated calcium level (hypercalcemia), while prolonged QT may be the indicator of low serum calcium level (hypocalcemia) in the blood. Prolonged QT may indicate a high risk of dangerous ventricular tachycardia.
QT dispersion is the difference between QT maximum and QT minimum, considered each ECG lead and a sole beat in a specific moment. QT dispersion gives information on the possibility of sudden cardiac death. But what constitutes a normal level of QT dispersion is still being debated.
T wave alternans is a beat-to-beat variation in the direction, shape and amplitude of T wave. It gives information on the risk of sudden cardiac death or other heart diseases.
A 24-hour Holter monitor is a perfect tool to detect rhythm disturbances and risk factors of heart disease.
Heart Monitor Types
Resting, Stress, Holter and Event ECG
There are a number of different types of heart monitors, included resting, stress and ambulatory ECG heart monitor. The latter relates to heart Holter and event recorders. The use of the different heart monitor types mainly depends on the aim of the ECG monitoring and the frequency of the symptoms or complaints.
Resting ECG Heart Monitor
Traditionally, ECG monitoring has been done in a clinical environment. The standard resting heart monitor usually records 12 channels with ten electrodes and suitable for evaluating irregular rhythms, blood and oxygen supply of the heart and other overall cardiovascular conditions. Monitoring your heart at rest usually takes 5 to 10 minutes.
Stress ECG Heart Monitor
Stress ECG Heart MonitorA stress heart monitor is used when you are taking exercises in order to give information on how the heart works under stress in a clinical environment. The stress test supports the diagnosis of coronary heart disease when the heart’s arteries become narrowed, and it may help the medical professional decide how much exercise is safe for you after a heart attack or heart surgery. During the stress heart monitoring, the patient rides on a bike or walks on a treadmill. This type of ECG monitoring takes about 15-30 minutes.
Ambulatory ECG Heart Monitor
Both a Holter heart monitor and an event recorder enable monitoring of the heart away from the clinical environment for a longer period. These are portable heart monitors.
A heart Holter monitor is usually applied for only a few days, most frequently up to 24 hours Heart Holter Monitor to record ECG signals continuously over a day and night when normal activities are carried out. A Holter heart monitor is useful to show the ECG abnormalities reflected in the shape and frequency of the heartbeats. A Holter monitor is an excellent tool to accurately monitor the ECG components, including P wave, QRS-complex and T wave, which all provide information on the patient’s heart conditions. Wearing a heart Holter monitor is indicated for detecting arrhythmias or for diagnosing atrial fibrillation, tachycardia, bradycardia, palpitations.
An ECG event recorder does not record ECG continuously, usually only when the symptoms occur. Therefore the event recorders have smaller memory because they store only a few hours of ECG. Usually, their memory can be overwritten, which makes it possible to wear these recorders for up to several weeks. An ECG event recorder is applied when the symptom does not occur very often, such as fainting or palpitations or an ECG event recorder is also useful in diagnosing silent ischemia, as it is not symptomatic.
The ECG wave
The ECG reflects the electrical activity of the heart, and normally it consists of a P wave, a QRS complex and a T wave. As the electrical impulse flows through the heart, a process of depolarization (action state) and repolarization (resting state) occurs. The P wave represents atrial depolarization, while the QRS represents ventricular depolarization, and the T wave shows the quick repolarization of ventricles. ECG can be used to monitor the abnormalities during the depolarization and repolarization process.
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