If problems arise with the heart, an electrocardiogram is not always informative. Often it is necessary to record the work of the main muscle of the human body for a longer time. For this, Holter heart monitoring is used.
Why Holter ECG is used and in what cases it is necessary, we will explain in this article.

Holter cardiac monitoring (24-hour ECG monitoring) is a method of continuous recording of an electrocardiogram (ECG) over a 24-hour period or longer using wearable cardiac recorders (monitors).

The essence of the study is to permanently record an ECG on a memory card located in the device. After processing this recording on a computer, the functional diagnostics doctor gives an opinion about the rhythm, its disturbances, ischemic changes, and the presence of pauses.

The method got its name from the name of the scientist who first used long-term ECG recording in 1952.

What is the method used for?

Before carrying out 24-hour ECG monitoring, the patient should be examined by a therapist or cardiologist. This is necessary for correctly completing a referral for research, clarifying the details of the examination (for example, stopping medications), and formulating a diagnosis.
Daily ECG monitoring reveals:

• type of heart rhythm and heart rate;
• rhythm disturbances (paroxysmal rhythm disturbances, pauses);
• ischemic ECG changes caused by;
• in some models – heart rate variability.

Daily ECG monitoring is used in the following situations:

• diagnosis for complaints of rapid or slow heartbeat, interruptions in heart function, irregular pulse, episodes of dizziness, severe weakness or loss of consciousness, a feeling of cardiac arrest;
• diagnosis of myocardial ischemia (oxygen starvation) with complaints of pressing, squeezing, burning pain behind the sternum, especially during exercise, before the appointment, complaints of a “lump in the throat” sensation, heartburn, episodes of pain in the lower jaw or elbows;
• monitoring the operation of the installed;
• monitoring the patient's condition over time, including monitoring the effectiveness of treatment.

How to prepare for the procedure?

In the morning before the examination, you must take a hygienic shower. Do not lubricate the skin with anything; it should be dry and clean. Men are strongly recommended to shave their chest hair: this will not only eliminate the painful removal of electrodes, but will also significantly improve the quality of the recording.

If you need to purchase batteries for the monitor, you need to pay attention to the markings. Batteries must be alkaline (alkaline), size AA (“finger”) or AAA (“pinky”).

If the adhesive plaster is poorly tolerated, it is advisable to purchase a special hypoallergenic silk-based plaster at the pharmacy. It will help avoid skin irritation.

Before the examination, it is advisable to get enough sleep, usually have breakfast, and take your time to come to the clinic. The patient will be more comfortable if he wears a tight-fitting T-shirt and loose clothing on top, under which the recorder can be hidden. Women are advised to wear a bra.

How is the examination carried out?

The nurse places round disposable electrodes on the front surface of the chest, securing them with adhesive tape. Most often there are 5 - 7 of them. Wires extend from the electrodes to a small device - a recorder. The recorder is hung on the patient’s neck (less often on the belt) in a special case. After turning on the recorder, ECG recording begins. After this there is no need to touch the monitor. You only need to press any buttons on it when you receive such instructions from the nurse, and this is not mandatory.

The patient is given an observation diary. In it, he must indicate the time of night's sleep (what time he went to bed in the evening, what time he got up in the morning). Some clinics recommend that the patient write down all his actions and sensations during the day. In others, it is recommended to perform several loads.

Most often, the patient is recommended to climb the stairs several times during the day until tired (without unnecessary effort), noting the start time of such a climb and indicating his feelings after the load. Such a diary entry will help the doctor determine the connection between ECG changes and stress and complaints.

If during the day the patient felt interruptions in the work of the heart, rapid heartbeat, dizziness or some other complaints, this should also be noted in the diary. There is no need to write in detail, the main thing is to indicate the time of such complaints.

It is worth noting the timing of medications. There is no need to constantly measure and record blood pressure. It is necessary to note the time of meals, rest, and emotional stress, if they somehow changed how you feel.

The patient should sleep as usual, but not lie on his stomach.

When the electrodes come off, you need to reattach them.

The next morning, the patient returns to the office to remove the monitor. After this, the recording is analyzed by a doctor. This process can take several hours, so most often the result is ready the next day.

During the examination, you must not pass through a metal detector in stores, stadiums, etc. You can use a mobile phone and a computer. X-rays or magnetic resonance imaging of any organs should not be performed. An ultrasound examination is possible as long as it does not affect the chest and interfere with recording.

Indications

1. Complaints of episodes of dizziness, loss of consciousness, heart rhythm disturbances.
2. Examination for previous history of hypertrophic cardiomyopathy and other severe heart diseases.
3. , long QT syndrome.
4. Suspicion of asymptomatic myocardial ischemia.
5. Suspicion of sleep apnea syndrome (a special program for apnea analysis is used).
6. Monitoring the operation of the pacemaker.

Contraindications

Daily ECG monitoring is not indicated for acute inflammatory diseases of the skin of the chest. There are no other significant limitations to this study. It can be performed at any age and with any concomitant diseases.

What to do after the study?

Analysis of daily ECG monitoring is a text with many terms, numbers, graphs and images that are difficult to understand for a non-specialist. Therefore, only a doctor can evaluate it correctly. Contact a specialist to clarify the diagnosis, prescribe additional research methods and treatment.

Video on the topic “Holter ECG”

An electrocardiogram cannot always detect cardiac pathologies. After all, the study is carried out for a short time and in a state of rest of the patient. 24-hour cardiac monitoring allows the patient to wear a device to record the activity of the main organ. The patient must know the rules for conducting this type of examination and fully comply with them.

Description of the method

Scientist Norman Holter was the first to develop and apply this technique, hence the name - Holter monitoring (or 24-hour heart monitoring). The patient must carry a small mobile recording device (recorder) with him at all times. Special bipolar leads are attached to the chest at the base and apex of the heart.

The entire diagnostic procedure consists of continuously recording heart rhythms, as when taking a cardiogram. The main difference is the duration of daily monitoring. During an ECG, 10-15 seconds are enough to record cardiac capabilities, but this data is often not enough to make an accurate diagnosis. Some pathologies appear periodically, during physical activity or, conversely, only at night.

Indications for testing

In cardiology, the method has been used for more than half a century and allows obtaining reliable data when a simple electrocardiogram does not detect disturbances in the functioning of the heart. There are quite a lot of cases when it is necessary to seek help from this particular diagnostic option. Daily heart monitoring not only reveals various abnormalities, but also allows you to evaluate the performance of the pacemaker.

Indications for using a Holter study include:

• Recent myocardial infarction.
• Heart rhythm disturbances (arrhythmia, tachycardia, angina).
• The patient complains of periodic pain and tingling in the heart area.
• Chronic heart failure.
• Silent ischemia.
• Dizziness of unknown etiology.
• Sudden shortness of breath.
• Chronic circulatory failure.
• Evaluation of the effect of certain medications on cardiac activity.
• Control study after completing a course of therapy.
• Examination before and after surgery.
• Changes in blood pressure.
• Feeling of suffocation and chest pain.

Diagnostics are mandatory for persons whose activities involve a high degree of responsibility (pilots, divers, crane operators, industrial climbers).

Types of examination

Depending on the indications, the doctor must select a specific type of study using the Holter method. Currently, full-scale diagnostics are more often used, in which a device for daily heart monitoring operates on a continuous basis for 24 or 48 hours. If necessary, the period can be extended to three days. In the first day alone, the device records up to 120,000 heartbeats. An electrocardiogram allows you to record no more than 50 beats in a short period of time.

The fragmentary type of survey involves continuous or periodic (event) recording. In the first option, recording the state of the heart begins from the moment the patient feels the symptoms of the pathology. To do this, he just needs to press a button on the device. The method is suitable even for cases where the patient has fainted. With daily heart monitoring in a fragmentary manner, the device will record the state of the heart some time before the patient can press the button after regaining consciousness.

The second type of fragmentary examination is necessary for patients in whom signs of cardiac disorders are observed quite rarely. A miniature device for recording information can be worn on the wrist. It is more convenient to use than one that still needs to be attached to the chest when symptoms are detected.

What does 24-hour heart monitoring show?

The Holter device detects any dysfunction of the heart in a variety of situations, not just at rest. This helps to detect the factor causing deviations.

Cardiac arrhythmia, which is characterized by a sudden appearance and disappearance, can be recorded exclusively by 24-hour cardiac monitoring. How is the examination carried out in this case? The most reliable result will be shown by a full-scale study. Thanks to this method, premature contractions of various parts of the heart, paroxysmal tachycardia (a sharp increase in the number of heart beats), and atrioventricular block (failure in the transmission of electrical impulses) are detected.

Carrying out the procedure

In order to obtain valuable and reliable information, it is necessary to correctly attach the electrodes to the chest. The wires coming from them are connected to a small recording device. The recorder itself is small in size and can be attached to a belt. Daily cardiac monitoring should be carried out even during sleep, so the patient must ensure that the device is connected.

Throughout the diagnosis, the patient leads a normal lifestyle, goes to work, and rests. You will also need to keep a diary where the following events that affect the functioning of the heart are recorded:

1. Morning awakening time.
2. Eating foods that can change your heart rate (coffee, strong tea, chocolate).
3. Any physical activity (jogging, climbing stairs).
4. Emotional stress.
5. Taking medications.
6. Bedtime time.

Sometimes doctors specifically prescribe certain actions for the patient, which he must perform and record the time in a diary.

Holter monitoring in pediatrics

Sometimes situations arise when daily heart monitoring for a child is prescribed by doctors (pediatrician, cardiologist) or sports coaches. The reason for this may be the need for a simple examination, for example, for more serious and heavy loads during training, or suspicion of a heart disease. For children, the device does not cause any discomfort and is attached in the same way as in the case of diagnosing the heart function of an adult.

The recorder can be worn around your neck or hidden in your pocket. All wires will be hidden under clothing. The child should adhere to the usual daily routine, attend classes at school or kindergarten, and walk outside. The device will record the work of the heart under different loads. The method allows you to determine possible deviations in the form of arrhythmia, bradycardia, tachycardia.

Patient preparation

No special preparatory actions are required to prepare for Holter monitoring. An exception is the preliminary manipulations that a man must perform. In order for the device to record true readings, it is necessary to shave the hair from the chest in the place where the electrodes will be attached. This will ensure proper adhesion to the skin.

Patients are interested in what 24-hour heart monitoring looks like and whether any discomfort is felt. There is no need to worry about this, since the electrodes are fixed on an area of ​​skin that has been previously lubricated with a special gel. The method does not cause any painful or unpleasant sensations.

General recommendations include taking a shower, because on the days of diagnosis, hygiene procedures will be limited. The functionality of the recorder may be somewhat affected by radio devices or a working microwave oven. The patient also needs to sleep on his back (or side) so as not to disturb the placement of the electrodes.

24-hour heart monitoring: what should not be done during the study?

The use of the recording device requires careful handling. Some manipulations can damage it or distort the results of diagnosing cardiac activity. To avoid negative consequences, you must first of all prevent the device from coming into contact with liquid. The mechanism will not withstand the shower test, so during the examination you will have to forget about water procedures for the upper body.

Patients are strictly prohibited from increasing physical activity without a doctor’s prescription! This can lead to serious consequences in the form of a heart attack, surges in blood pressure, and stroke.

The Holter device should be protected from direct sunlight and electromagnetic waves. This can significantly affect the final result of cardiac monitoring. You should choose the right clothing while wearing the device. It is advisable not to wear tight clothes and avoid synthetic material that does not allow air to pass through well. The electrodes will quickly move away from a wet surface.

Holter monitoring is used to obtain accurate information about the function of the heart muscle. The device is attached to the patient's body using electrodes and is not removed for at least a day. Thanks to such an examination, it will be possible to record even minor short-term pathologies that are not detected during the standard ECG procedure.

Daily monitoring is an examination method during which the activity of the heart is continuously recorded.

Such diagnostics are carried out with a special small device - a holter, which makes it possible to measure:

• pulse;
• rhythm variability, its episodes;
• pauses;
• supraventricular and ventricular ectopic activity.

What does a holter look like and work?

The Holter has two main parts: a stationary decoder and a recording device that takes readings. The sensor is fixed using disposable electrodes attached to the least mobile skin (this prevents the risk of equipment malfunctioning).

The devices used to implement the procedure may differ in the number of recording channels. The 12-channel device is considered the most informative, allowing one to obtain significantly more information about arrhythmias.

The principle of Holter operation is that the device takes heart rate readings during the patient’s usual lifestyle:

• during physical activity;
• when eating;
• during sleep, etc.

After the procedure is completed, a graph of changes is displayed on the computer screen, after analyzing which the doctor will be able to make an accurate diagnosis.

Photo gallery

Photo of Halter Placement on the patient's body

Difference from a regular ECG

Traditional electrocardiography differs from a Holter study in that it is a less effective method. Thanks to it, you can evaluate the work of the organ only in a calm state (in an office environment).

Holter monitoring is used in medicine to monitor heart function under various living conditions. This method in cardiology is highly effective and allows you to register intermittent moments of ischemia caused by various circumstances (internal experiences, stress).

The Holter method makes it possible to compare:

• patient complaints;
• picture of an electrocardiographic study when symptoms appear;
• a description of what the subject was doing at that time.

What does it show?

Using this diagnostic method it will be possible to determine:

• arrhythmia (irregular heart rhythm);
• blockades (impaired conduction of impulses);
• ischemia (deterioration of blood supply);
• effectiveness of the pacemaker.

In addition, the device measures the subject’s blood pressure and records it at certain intervals.

Indications for use

Holter is placed when the patient is bothered by the following symptoms:

• burning or pain in the chest area;
• intense heartbeat;
• frequent dizziness or fainting;
• feeling of “fading” of the heart;
• severe shortness of breath.

It is necessary to prescribe the procedure when conventional cardiography and ultrasound do not show any abnormalities, but the patient continues to be bothered by unpleasant symptoms.

Contraindications and side effects

Holter monitoring is prohibited for people with skin diseases in the chest area. There are no other restrictions for prescribing an examination.

The method does not cause any side effects.

Safety of the procedure

The patient can be confident in the harmlessness of the device, because its use does not cause pain or subsequent complications. Patient reviews indicate that wearing the device is not accompanied by any discomfort.

Types of research

The Holter system allows for several ways to examine the heart: fragmented and full-scale.

Fragmented monitoring

Fragmentary monitoring allows the patient to turn on the device to record a cardiogram when unpleasant symptoms appear.

Full-Scale Monitoring

Full-scale monitoring is characterized by continuous recording of heart function for 24–72 hours. It can be carried out to identify hidden pathologies of the cardiovascular system.

Sometimes diagnosis requires a full examination, which is carried out over 1–12 months. This procedure is carried out by subcutaneous implantation of a Holter monitor.

Preparing for the examination

On the eve of Holter monitoring, the following recommendations should be followed:

• take a shower;
• do not use body creams (skin should be clean and dry);
• men suffering from excess hair growth should undergo breast depilation;
• purchase a hypoallergenic patch (in case of hypersensitivity);
• sleep well;
• get to the clinic at a calm pace.

If the patient is taking any medications, the doctor must be informed about this.

How is monitoring carried out?

To carry out the procedure, the subject must undress to the waist. After which the doctor degreases the surface of the skin with alcohol and installs the device.

Installation of the device and arrangement of electrodes

Correct installation of the holter involves the following actions:

1. Application of disposable electrodes to the chest.
2. Attaching the sensor using wires. Its display can monitor the electrical activity of the heart.
3. Installation and fastening of the device on the subject’s belt or in another place convenient for him.

Sensor Layout Scheme

The video describes in detail how electrodes should be placed during Holter monitoring. Published by INKARD channel.

What to write in your diary

Once the device is installed, the patient is given an organizer to record key moments of their day.

It is imperative to indicate the time in the diary:

• taking medications;
• eating food;
• stress;
• physical downloads.

If the patient felt unpleasant symptoms during the electrocardiogram (nausea, increased heart rate, dizziness), they also need to be listed in the diary.

What not to do?

During the procedure it is prohibited:

• wear synthetic, loose clothing;
• overcool or overheat the device;
• wet halter;
• place objects that vibrate on the device;
• be near a microwave oven;
• use a mobile device or laptop for more than three hours a day;
• lie down or sit on a halter;
• take x-rays during the examination.

Can it be used by pregnant women and children?

The use of the device has no age restrictions and is also harmless during pregnancy.

Pediatric Holter monitoring is no different from the standard procedure for adults. It is first recommended to explain to the child the rules of behavior with the device, reassure him and warn him that this method is painless.

Results and data decoding

Analysis of the provided data and comparison of it with the examination result will allow us to determine abnormalities in the functioning of the heart.

Index	Norm
Average heart rate during the day	60-100 beats per minute
Average heart rate at night or during daytime sleep	41-81 beats per minute
Graph of changes in heart rate per day	May vary depending on activities
Number of supraventricular extrasystoles	Up to 960 per day (40 pieces per hour) A slight excess of the norm (up to 1200 per day) does not pose a threat to the health and life of the patient
Number of ventricular extrasystoles	Perfect norm – 0 Up to 200 per day does not pose a threat to the health and life of the patient
The duration of the QT and PQ intervals and the schedule of their changes	Normal QT interval: 340–450 ms (0.34–0.45 s) for women and 340–430 ms for men PQ – 120–200 ms

Such characteristics of the norm are generalized and do not take into account the individual and age characteristics of the body.

Is it possible to deceive Holter?

It is impossible to deceive the holter. If taking antihypertensive drugs can lower blood pressure, then arrhythmia and other heart problems cannot be hidden. Experienced doctors will definitely pay attention to them and prescribe additional examination.

Requirements for the level of preparation of a 4th grade student Literary reading 1. Know the distinctive features of works of folklore: epics, riddles, tongue twisters, legends, traditions, sayings and proverbs, nursery rhymes, fairy tales, fairy tales. 2. Literary (author's) and folk tales (everyday, fairy tales, about animals). 3. Literary genres: saying, fairy tale, fairy tale, play, scientific and artistic work, oral folk art, poem, fable, ballad, legend, myth, epic story, essay 4. Theme, idea of ​​the work (about children, about the Motherland, about nature, fantasy, etc.) d.) 5. Literary hero (characterize, describe, plot, episode) 6. Visual and expressive means of language: epithet comparison personification hyperbole 7. Reading technique and reading comprehension (120 - 150 words) - determine the topic, structure of the text, main the idea of ​​the work and correlate it with the title; - correlate the main content of the text with illustrations; - establish connections within events; - divide the text into semantic parts and compose a simple retelling; - use types of retelling (selective, brief, detailed) and distinguish between them; - briefly characterize the main idea of ​​a work of art; - describe the heroes of the work (their actions, characters); - express your attitude to the work you read; 8. Reader's horizons: find bibliographic information about the book (author, title page, abstract, table of contents); work with an encyclopedia, dictionary and reference book; know the difference between types of books (reference, educational, popular science) 9. Creative activity of students: summaries and short essays on the texts of literary works; writing riddles, nursery rhymes, sayings, fairy tales; writing reviews about the book you read; Requirements for the level of preparation of a 4th grade student Russian language 1 block “How our language works” 1. Phonetic analysis of the word; 2. Analysis of the word by composition; 3. Preposition, prefix; 4. Morphological characteristics of parts of speech; 5. Main, secondary members of the sentence; 6. The grammatical basis of the sentence; 7. Sentences (types of sentences according to the purpose of the statement and intonation); 8. Homogeneous members of the sentence; 9. Polysemantic words, synonyms, antonyms; 10. Lexical meaning of the word in the explanatory dictionary. Block 2 “Spelling” 1. Voiced and voiceless consonants; 2. Unpronounceable consonants; 3. Unstressed vowels; 4. Separating ь and ъ sign; 5. Soft sign after hissing nouns at the end; 6. Soft sign after sibilants at the endings of 2nd person singular verbs; 7. Unstressed case endings of nouns and adjectives; 8. Unstressed personal endings of verbs; 9. Adverbs ending in hissing, vowels at the end of adverbs; 10. Punctuation marks at the end of a sentence, a comma between homogeneous parts of the sentence. 11. Correcting errors in sentences; 12. Practicing spelling rules. Block 3 “Speech development” Students must distinguish between: - text or non-text. Solve practical and educational problems: - highlight the main idea of ​​the text; - select a title for this text; - correct deformed text; - draw up a text plan, create your own text according to a given plan; - find linguistic means that make the text expressive; - write statements (detailed and concise, selective, with elements of an essay); - write essays (narrative essays, reasoning essays, descriptive essays). Requirements for the level of preparation of a 4th grade student Mathematics Line of arithmetic development: multi-digit numbers (their reading, writing and comparison); four arithmetic operations with numbers within the millions class (including multiplication and division by a three-digit number); properties of actions and their application to calculations. The line of development of the concept of quantity: angle and its designation. Types of angles. types of triangles depending on the size of the angles (acute, rectangular, obtuse). types of triangles depending on the length of the sides (scalene, isosceles, equilateral). exact and approximate values ​​of a quantity (with a deficiency, with an excess). Measurement of length, mass, time, area with a given accuracy. The line of development of logical-mathematical concepts and mathematical relations: complex statements using conjunctions and; or; if, then. Line of algebraic development: expressions with two and three variables are introduced, containing more than one occurrence of the same variable, the values ​​of such expressions are calculated; familiarization with simple equations, finding the root of an equation. Line of the geometric part of the course: geometric figures: flat - polygon, segment, circle, broken line; spatial - ball, cylinder, cone, pyramid, prism; axial symmetry. It is necessary to work on: complex equations (not provided by the program) four arithmetic operations (addition and subtraction within a million, multiplication and division by two-digit and three-digit numbers) properties of actions and their application (combinative, commutative and distributive) solving problems on movement, finding the perimeter, square, one of the sides Requirements for the level of preparation of a 4th grade student The world around us As a result of studying the course “The world around us”, students must name (give examples): signs of a living organism; signs characteristic of humans (as opposed to animals); the main organs and systems of human organs and their functions; healthy lifestyle rules; rights of citizens and children in Russia; the main rulers of the Russian state (prince, tsar, first and last emperors); peoples inhabiting Russia; distinguish (correlate): year and century, Arabic and Roman numerals; artificial bodies and natural bodies; good and bad habits; emotional state and feelings of others; solve problems in educational and everyday situations: reveal the causes of individual events in the country, the causes of wars, the dates of the main wars in the history of Russia; find out from the text what time this event belongs to; compose a coherent story on the following topics: “Man is a biological being”, “How to be healthy”, “How to develop your memory”, “If trouble happens”, “How man differs from animals”, “Native land”; explain the meaning of the concepts “man is a living organism”, “healthy lifestyle”, “bad habits”, “state”, “child’s rights”; apply the rules of moral behavior in everyday life; work with geographical and historical maps; complete tasks on the contour map. It is necessary to work out: natural zones of our Motherland (where it is located, main features: climate, vegetation, fauna, human occupations) minerals (appearance, properties: strength, color, application, where they are mined)

They are attached to the patient, most often on a belt, in a special case. halter and apply electrodes. Doctors often use the phrase “hang up the Holter” or “make a Holter”, meaning that the device will be used for 24 hours, on an outpatient basis, in the patient’s usual living conditions - at home, at work, during night sleep. Patients are asked to Do not wet the device, but otherwise lead a normal lifestyle.

This process of taking readings is called Holter monitoring, named after the American research scientist Norman J. Holter, who first used this technique in 1961.

Why do you need a holter?

It would seem, why do you need a Holter if you can just go to the doctor and take an ECG? Often, people with heart health problems have the following situation: they have complaints, but they arise when it is not possible to immediately see a doctor - in the evening, at night, during some events.

The catcher goes to the clinic the next day, an ECG is taken, but no abnormalities are found. Why might this happen? Because a standard electrocardiogram is a record, like a “snapshot,” that records cardiac activity over a short period of time. A regular ECG records only a few myocardial contractions: from three to twenty, depending on the cardiograph used for this purpose. Whereas the heart contracts about 100 thousand times per day! Holter records an ECG throughout the day, and not a single heartbeat during this period will go unnoticed by the device, because the electrocardiogram is recorded continuously. Holter makes available for analysis that information about the patient's heart health that cannot be obtained during a short visit to the doctor, and this is the most important diagnostic value of this device.

Then halter removed from the patient, and with the help of a special computer program that processes the data obtained, they identify and analyze all types of heart rhythm disturbances, painless and painful attacks of myocardial ischemia, etc. Holter is a device that allows both accurate diagnosis of heart disease and and helps to treat cardiovascular diseases - hypertension, atherosclerosis, heart attack, myocarditis - much more effectively. 24-hour monitoring, which Holter proposed, is a procedure that identifies almost all possible cardiac abnormalities that appear during the day, which cannot be done using other methods of cardiac diagnostics currently used.

Holter monitoring is a simple and safe procedure. In order to carry it out, two visits to the doctor will be required. On the first visit, the holter is programmed and installed on the patient; this procedure takes no more than a quarter of an hour. In a day, the holter will need to be removed and its records analyzed. These actions usually take the doctor about half an hour or an hour - in more complex cases. Modern clinics often offer Holter monitoring at the patient’s home: all necessary visits are made by the doctor himself. This is certainly very convenient, especially if the study is required by an elderly, sedentary person.

How to deceive Holter?

Very often, patients of military age try to deceive the holter by running tirelessly up the stairs and bringing themselves to complete exhaustion, imitating tachycardia. But I hasten to disappoint those who came here in the hope of learning how to deceive Holter - Meditech 24-hour blood pressure and ECG monitors are equipped with special sensors that, together with an experienced doctor, always recognize malingerers.

When is a halter needed?

Holter monitoring may be indicated for a patient if:

1. there are complaints resulting from heart rhythm disturbances (palpitations, dizziness, loss of consciousness);


2. diagnosis of coronary heart disease is required;
3. it is necessary to preventively monitor patients with threatening ischemia and arrhythmias;
4. it is necessary to evaluate the effectiveness of the treatment;
5. white coat hypertension is present;
6. arterial hypertension has been detected for the first time, and the heart needs to be examined in order to decide whether to begin drug therapy;
7. the fact of chronic constitutional hypotension was revealed;
8. Moderate to severe hypertension, resistant to previous treatment, was diagnosed.

In addition, it is advisable to use a Holter if the patient has congenital heart defects, both unoperated and operated, or if he has suffered a myocardial infarction; to evaluate the performance of a pacemaker; in all cases of acute and chronic heart failure. A Holter monitoring procedure would be useful for people who are overweight (obese) or have diseases of the endocrine system.

How to prepare for Holter monitoring?

If the patient is to wear a halter, then during the 24 hours during which the study will be carried out, he must live his normal life - work, rest, meet people, and perform his usual physical activities. Some doctors, when installing a holter for their patients, ask them to keep an activity diary during the 24-hour examination.

This diary should record everything that affects cardiac activity: sleep, medication, movements, etc. This is not always necessary. Firstly, because constant attention to the process on the part of the patient can affect the reliability of the result (the person will only think about what the Holter shows in the event of one or another action). And, secondly, a modern holter can have a built-in sensor that records the patient’s physical activity, from which it is possible to determine at what moment the patient was sleeping and at what point, for example, he was running in the park. During the analysis, these points are clarified.

Modern Holter records not only electrocardiogram, but carry out actigraphy(this is the recording of the patient’s physical activity) and controls arterial pressure. The software, which is used to analyze the parameters recorded by Holter, allows you to effectively and quickly identify both heart rhythm disturbances and obtain a clear picture of how the autonomic nervous system regulates the functioning of the heart.

During Holter monitoring, no special actions need to be taken. You just need to remember that halter- This is a complex, expensive electronic device, and the attitude towards it must be appropriate. This means:

• The halter should not be wet - take a bath, shower, or swim in open water with it;
• Do not expose the holter to low or high temperatures (for example, do not go to the bathhouse on the day of the test);
• The device must be protected from shock and vibration. It is advisable to avoid contact with aggressive household chemicals, especially those containing acids, during Holter monitoring.

In addition, heavy, prolonged physical activity is very undesirable, since, firstly, it can distort the results of the study, and secondly, due to increased sweat, the electrodes may come off.

During the examination, it is better to give preference to cotton underwear and avoid wearing clothes made of synthetic and silk fabrics, which can accumulate static electricity.

Holter - This is a medical device with which daily monitoring of heart activity is carried out - an important and serious study, the relevance of which is undeniable these days.

formed.ru

What is the method

Currently, 24-hour Holter monitoring or Holter monitoring is popular. For this purpose, a portable recorder is used, which records an electrocardiogram around the clock and transmits information to a computer. The program installed in it provides diagnosis of any heart rhythm disturbances, as well as painful and painless attacks of myocardial ischemia. This examination method makes it possible to make an accurate diagnosis, which significantly increases the effectiveness of treatment of cardiovascular pathologies (hypertension, heart attack, atherosclerosis and myocarditis).

How to prepare for monitoring

Considering that the medications taken by the patient affect the functioning of the heart, it is necessary to inform the attending physician about them before conducting the examination. When repeat monitoring, it is advisable to provide previous ECG results. Before the procedure, you should take a shower, since it will be impossible to do this when installing the electrode and device on the patient’s body. During monitoring, wearing metal objects (jewelry and clothing parts) is prohibited.

Technique of the procedure

A recorder is placed on the subject's body and secured with a strap on the shoulder or wrist. An electrode in the form of a disk is attached to the chest. It receives heart impulses, which are transmitted to the device and recorded. After this, the electrode is connected to a conventional cardiograph for a while to ensure that it is installed correctly.

During monitoring, the patient is recommended to keep a diary with notes on his physical activity and the symptoms of the disease that appear at this time. If you experience dizziness, chest pain, palpitations or fainting, you need to press the record button on the device and make an entry in your diary.

At the end of monitoring, the doctor removes the recorder and electrode. Data from the seized cassette is transferred to a computer and analyzed. After this, these data are compared with the entries in the diary, that is, it is assessed what is causing the change in heart rate on the cardiogram.

Are complications possible?

As a rule, patients tolerate Holter monitoring well, with no complications noted. After all, no electric current passes through the electrode; it only picks up minor signals that arise when the heart is working.

www.kakprosto.ru

The essence of the study

The procedure is an instrumental technique. It is designed to identify pathologies in the functioning of the heart muscle.

During the examination, the functioning of the cardiovascular system is monitored:

• The data is taken using electrodes attached to the skin in the sternum area, then transferred to a recorder - a special device that reads the information and stores it until decrypted;
• Deviation of parameters from the norm serves as a basis for identifying serious diseases;
• Modern devices are equipped with electronic memory, while older models use magnetic tape for recording;
• For fragmented monitoring (carried out only during attacks of pain or discomfort), there are miniature devices that fit in the palm of your hand.

The order of the study, how it is carried out

What is it used for?

A referral for daily ECG monitoring is given by a cardiologist or therapist after a preliminary examination, during which a diagnosis is formulated and details are clarified (for example, a list of medications taken).

Daily ECG monitoring is used to detect:

• type of heart rate and heart rate periodicity;
• pathologies (pauses, extrasystoles, paroxysmal disorders);
• heart rate variability;
• oxygen deficiency (ischemia), in which patients usually complain of a “lump in the throat,” heartburn, burning or pressing pain behind the sternum, soreness in the elbows and lower jaw;
• malfunction of the pacemaker;
• dynamics of health status, assessment of treatment effectiveness.

What does monitoring show?

1. How rhythmically the heart muscle contracts.
2. If a rhythm disturbance is detected, does it pose a danger? Is there a possibility of death, is surgery necessary?
3. The nature of the pain bothering the patient. Is their source from the heart, is it affected by physical activity and stress.
4. The cause of fainting and pre-fainting conditions.
5. Allows you to evaluate how effective the prescribed antiarrhythmic therapy is and monitor the work of the pacemaker.
6. Changes in the rhythm and work of the heart during sleep.
7. Threat of myocardial infarction. If not enough nutrients are reaching the heart muscle, the Holter will show this.

Indications for use

Typically, the reason for installing a device that allows recording the dynamics of blood pressure and electrocardiogram is the patient’s complaints:

• cough, shortness of breath, feeling of lack of air, not associated with diseases of the bronchopulmonary system;
• sudden dizziness, fainting;
• attacks of cardialgia (pressing and burning pain behind the sternum in the area of ​​the heart muscle);
• excessively rapid heartbeat at rest or under special circumstances (stress, exercise, eating);
• "heart sinking"

In the above cases, the role of 24-hour Holter monitoring plays the following role:

• determines under the influence of which factors the failure occurred, whether there is a dependence on the time of day and other circumstances;
• investigates the cause of poor health: coronary artery disease or interruptions in rhythm and conduction;
• establishes the factor of cardiac dysfunction.

Also, the need to conduct heart monitoring using the Holter method may arise when:

Contraindications

This type of study of cardiac activity has no contraindications. If necessary, it can also be used for pregnant women. Monitoring for children is carried out according to the same scheme as for adults.

But in some patients, conducting the study may be technically impossible due to:

1. severe degree of obesity;
2. severe chest injuries;
3. the presence of wounds or burns in the area where the electrodes are attached.

Preparation for the procedure

1. If prescribed by a specialist, a standard cardiogram can be drawn up before the study.
2. Men are advised to shave their chest hair. This is necessary so that the electrodes are securely attached to the skin, and the information received is reliable.
3. Before the procedure, you should thoroughly cleanse the skin and take a shower.
4. The body must be dry; after water procedures, gels, creams and other moisturizers should not be applied.
5. If the patient is taking any medications, it is important to notify the specialist about this. He may cancel your appointment during the study period.
6. Sometimes the doctor asks you to bring batteries for the device. When purchasing them, pay attention to the labeling. Choose alkaline batteries; their standard size can be AA or AAA; check this by studying the instructions supplied with the device.
7. If a patient is allergic to contact with an adhesive plaster, he should buy a product marked “hypoallergenic” at the pharmacy. A silk-based patch will also work.
8. Before the study, you need to get a good night's sleep and have breakfast.
9. To place the monitor comfortably, it is best to wear a T-shirt and a loose-fitting sweater or shirt over it.

Decoding the results

The main amount of work when conducting research is deciphering the data obtained. A day later, the device is disconnected from the patient, connected to a PC and the information is assessed. The device stores a significant amount of information and the doctor must take into account a number of parameters when drawing up a conclusion.

There is no single form for writing a daily monitoring report, but it must necessarily include the following points:

• heart rate, source;
• deviations of the ischemic index;
• duration of pauses in heart contractions (for adults the norm is up to 1750 ms, for infants - from 1000 ms);
• ST index;
• description of the dynamics of the QT, PQ intervals. For adults, the normal duration of the QT interval is 500 ms, for infants from 400 ms;
• stability/changes in the morphology of the QRS complex;
• if a pacemaker is present, the functioning of the device is analyzed;
• The observation diary is studied and data on changes in the ventricular complex are presented.

The data stored in the device must be deciphered by a cardiologist. The specialist adjusts the values ​​based on the patient’s records. If deviations from the norm are detected, the doctor attaches an ECG to the transcript, which reflects the signs of pathology.

The importance of conducting a Holter ECG is undeniable. It helps the cardiologist to timely identify and begin treatment of such serious diseases as hypertension, ischemia and others.

cardiohelp.com

Types of Holter monitoring

Holter cardiac monitoring can be carried out in two forms - full-scale monitoring and fragmented monitoring of cardiac activity. In some cases, Holter monitoring is used in parallel with 24-hour blood pressure monitoring. Full-scale monitoring is carried out for three days, which makes it possible to better examine the work of the heart and identify peculiarities in its functioning. In this way, you can notice when murmurs occur, what provokes tachycardia, etc. During this time, the receiver records information about more than one hundred thousand heart beats.

An electrocardiogram records an insignificant fraction of beats - only about fifty, so the value of Holter monitoring is much higher than the value of the usual ECG. A fragmentary study is prescribed for those patients who experience heart pain less often. To manage the patient, a regular electrocardiogram is taken, and the Holter monitoring device is activated by the patient when he feels unpleasant pinching or stabbing pain in the chest.

Principles of research

Holter monitoring has some features. In order to obtain objective data on the work of the heart, it is necessary to understand how the study is carried out and what rules the patient must adhere to so that the monitoring data is as close to reality as possible and becomes useful for further treatment.

Monitoring is not a complex or time-consuming procedure. The doctor sticks electrodes to the patient in certain places on the chest, and then connects them to the recording device. The device itself fits into a special bag or is fastened to a belt, like a mobile phone in a case. The weight of the device is not great, it does not interfere with walking.

Patient's responsibilities during monitoring

Usually, before the procedure, the patient is given a memo, according to which he must fulfill all the requirements contained in the text. During monitoring, the patient must keep a diary of his activities, where he will record the following items:

• a) time of awakening and time of sleep;
• b) the presence and type of physical activity per day;
• c) a list of medications taken;
• d) the presence of stressful situations;
• e) number of meals;
• f) the presence of pain symptoms from the heart, their duration, the nature of the pain.

Limitations during the procedure

Holter cardiac monitoring is a very delicate and sensitive study, which must be carried out in compliance with strict rules for the patient. Basically, these rules concern restrictions that cannot be neglected, otherwise the results of the study will not be reliable and the treatment will be in vain. So, the patient should know what not to do during Holter monitoring, namely:

1. Do not carry out any actions with the device that were not told to him in the medical institution.
2. Make sure that no liquid gets on the device and sensors, otherwise the results will be incorrect and the study will have to be stopped.
3. Observe the fastening of the electrodes, and if the electrode is disconnected, be able to independently secure it at the required point.
4. Do not overheat or overcool the device (for example, use heating pads).
5. Do not attach receiving sensors to other places.
6. Do not perform radiographic examination.
7. Make sure that the device does not come into contact with active chemicals.
8. Do not undergo physical therapy procedures.
9. Do not include heavy physical activity in your daily routine. Going to the gym is strictly prohibited, but in some cases the doctor may specifically prescribe a controlled exercise - climbing stairs or a short run - to record cardiac activity at this time.
10. Minimize exposure to radio waves - turn off your mobile phone (if possible), do not heat food in the microwave, do not sit near players with built-in radios, etc.
11. Do not perform hygiene procedures in the chest area, do not take a shower.
12. When sleeping, do not roll over on your side, sleep on your back all the time so that the electrodes do not become disconnected.
13. Wear clothes made from natural fabrics that prevent the body from overheating and sweating.

The cardiologist will be able to speak about the final diagnosis after monitoring when he deciphers the receiver data. These results are compared with the data of the electrocardiogram, ultrasound examination and other diagnostic procedures that were prescribed to the patient.

As practice shows, it is daily Holter monitoring that is decisive in determining the pathology of the cardiovascular system in a patient. It is very important that the patient diligently keep a diary and become familiar with all the restrictions that must be adhered to during the study. Only through mutual efforts will the patient and the doctor be able to contribute to the diagnosis of cardiac pathology.

What is low blood pressure in humans?