A traditional electrocardiograph takes under 5 minutes to perform and records the heart’s electrical activity for the time period of the test only. While this is useful in helping to detect heart disease or to find evidence of a previous heart attack, sometimes doctors will want the electrical activity monitored continuously for 24 hours to get a more accurate description of the heart’s activity. When this is the case, a continuous ambulatory electrocardiograph (CAE) is used.
Also called a Holter Monitor, a CAE is a small monitor that continuously records the heart’s electrical activity via electrodes that are attached to the chest. This is most often used for patients who have cardiac arrhythmias that can’t be observed in the short amount of time that an ECG takes. Arrhythmia is defined as the irregular beating of the heart and can take place in several forms, including Tachycardia, which occurs when the heart beats too quickly, usually over 100 beats per minute; Bradycardia, where the heart beats too slowly, (under 55 beats per minute in an adult), and other arrhythmia problems, which include extra heartbeats or skipped heartbeats.
The patient wears the monitor continuously for the next 24 hours and keeps a written record of symptoms they experience and the time, as well as activities such as sleeping or exercise. This helps the doctors pinpoint trouble times and sift through the large amount of data the CAE will record.
What to Expect
If your doctor decides to outfit you with a CAE, you can expect it to take about 15 minutes to install the monitor. They will clean with an alcohol solution to make sure the electrodes fit securely on the chest. A series of thin wires are connected the electrodes to a small tape recorder, which is then affixed to the patient’s belt. Sometimes, patients opt to wear it over their shoulder in a pouch. The doctor will then give you instructions on how to use it.
Most people wear the recorders for 24 hours, although some are asked to wear them for as long as 30. You will not be able to shower, bathe, or swim during the test to avoid getting the monitor wet. The CAE is safe and pain-free.
You will also be asked to keep a so you can make note of your activities, such as going for a walk, exercising, or getting into an argument, as well as any symptoms you may experience, like skipped heartbeats, chest pain, or fatigue as well as the time the symptom occurred. Many of the monitors have a button called “event” in which you can press and then print out the readings at which the symptoms occurred. The ECG is run through a computer, which then analyzes the rate and rhythm of the heart as well as looks for changes in electrical activity that could indicate other serious problems, such as an inadequate flow of blood to the heart.
After the 24 hours, the monitor will be removed and the information is compiled and recorded by a technician, then sent to your doctor. Unless the technician notes a life-threatening condition and your doctor is immediately notified, it will usually take a few days to get the results back. From there, the doctor will decide on the best approach for treatment based on the diagnosis of the form of heart disease. Sometimes, the results will require additional equipment, such as a pacemaker, in order to correct abnormal heart rhythms.