Cardiac Monitoring

Cardiac monitoring allows your doctor to remotely monitor and manage your heart rhythm. Because abnormal heart rhythms and their accompanying symptoms often come and go, continuous cardiac monitoring is necessary to determine the cause of fainting, palpitations, unexplained stroke or atrial fibrillation. Monitoring your heart over time allows the doctor to make an accurate diagnosis.
Your doctor may consider two types of monitors

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Holter Monitor

Your doctor uses cardiac monitors to diagnose arrhythmias and determine if your heart rhythm problem requires treatment. A Holter monitor records your heart's electrical activity the entire time you wear it, between 24 and 48 hours. You may pick up your monitor at your cardiologist's office or at the Cardiac Services Department at Doylestown Hospital.

What does it show?

Holter monitors record your heart's electrical activity, providing your doctor a more complete record of your heart rhythm than a routine EKG, which lasts about 30 seconds. You also take detailed notes in a diary, recording your exact symptoms, what time they occur, and what you are doing while they occur.

How do I prepare?

Before giving you a monitor, your doctor will perform a physical exam which may include an EKG. A technician cleans five areas on your chest and places five electrodes (small sticky patches) on these areas which connect by wires to the monitor. The technician secures the wires with additional tape and you clip the monitor to your belt or carry it in your pocket. The technician will provide instructions on how to use the monitor. You follow your usual daily routine and keep a diary of your activities and any symptoms. Write down any medications you take and when you take them. Note the time you develop symptoms so your doctor may compare your notes with the results of the EKG.

How do I care for the monitor?

Holter monitors are safe to wear and there are no risks. Here are few tips:

  • Wear a loose-fitting top when you receive your monitor
  • Do not get the wires, electrodes, or monitor wet
  • Do not bathe or shower while wearing a monitor
  • Keep electronic devices (including smartphones) at least six inches away from the monitor
  • Bring the diary with you when you return the monitor

How will I get results?

When you return the monitor, a technician scans the recorded tape, then a cardiologist reviews the report and talks with your doctor. Your doctor will contact you with the test results as soon as they are available, usually within a week.

Holter Monitor

Your doctor uses cardiac monitors to diagnose arrhythmias and determine if your heart rhythm problem requires treatment. A Holter monitor records your heart's electrical activity the entire time you wear it, between 24 and 48 hours. You may pick up your monitor at your cardiologist's office or at the Cardiac Services Department at Doylestown Hospital.

Holter monitors record your heart's electrical activity, providing your doctor a more complete record of your heart rhythm than a routine EKG, which lasts about 30 seconds. You also take detailed notes in a diary, recording your exact symptoms, what time they occur, and what you are doing while they occur.

Before giving you a monitor, your doctor will perform a physical exam which may include an EKG. A technician cleans five areas on your chest and places five electrodes (small sticky patches) on these areas which connect by wires to the monitor. The technician secures the wires with additional tape and you clip the monitor to your belt or carry it in your pocket. The technician will provide instructions on how to use the monitor. You follow your usual daily routine and keep a diary of your activities and any symptoms. Write down any medications you take and when you take them. Note the time you develop symptoms so your doctor may compare your notes with the results of the EKG.

Holter monitors are safe to wear and there are no risks. Here are few tips:

  • Wear a loose-fitting top when you receive your monitor
  • Do not get the wires, electrodes, or monitor wet
  • Do not bathe or shower while wearing a monitor
  • Keep electronic devices (including smartphones) at least six inches away from the monitor
  • Bring the diary with you when you return the monitor

When you return the monitor, a technician scans the recorded tape, then a cardiologist reviews the report and talks with your doctor. Your doctor will contact you with the test results as soon as they are available, usually within a week.

Implantable Monitoring Devices

Implantable cardiac monitors detect and correct your irregular heartbeats (arrhythmias). The ICD and LINQ help if you are at risk of sudden cardiac arrest.

Implantable Cardioverter Defibrillator (ICD)

Your electrophysiologist places the ICD in your chest or abdomen. It uses electrical pulses to control life-threatening irregular heartbeats and requires up to three wires, called leads, which are placed in the blood vessels in your heart's cavity. They provide an electric pulse to your heart. An ICD may be used if you have survived a cardiac arrest or have a weakened heart muscle.

The newest option is the subcutaneous implantable defibrillator (S-ICD) system. Your electrophysiologist implants it just below your skin on the left side of your chest and there are no wires placed in your heart, which makes it more manageable and comfortable.

Reveal LINQ™ ICM

The Reveal LINQ™ ICM is a miniature wireless cardiac monitor designed to help your doctor diagnose and monitor patients who have or may have atrial fibrillation (AFib). The device is one-third the size of a AAA battery and allows your doctor to monitor your heart remotely for up to three years. It is placed just beneath your skin on the upper left side of your chest and is performed in a quick outpatient procedure that requires local anesthesia. It is similar to an injection and nearly invisible once inserted.

Cardiac Resynchronization Therapy (CRT) Device (Pacemaker)

A cardiac resynchronization therapy (CRT), commonly referred to as a pacemaker, is used to treat heart failure. A CRT sends small electrical pulses to the lower chambers of your heart which helps them beat together and become more synchronized. This allows your heart to work more efficiently as it pumps blood and oxygen to your body. The device is a small and lightweight computer that runs on a battery that your medical team places under your skin below your collarbone. The device's leads (wires) are threaded through a blood vessel into your heart and is programmed through a computer located in your doctor's office. The device retrieves information about your heart to help your doctor treat your heart failure.

Medtronic Micra ™ Leadless Pacemaker

The world's smallest pacemaker, the Medtronic Micra™ does everything a traditional pacemaker does, but it is just one-tenth the size. The device, a tiny capsule less than an inch long, is implanted without invasive surgery directly into the heart wall, resulting in no scarring or evidence of the pacemaker outside the body. Approved by the FDA in April 2016, benefits of the leadless design include reducing infection risk and eliminating the issue of leads dislodging with movement, allowing you to get back to activity quicker after the procedure.

Implantable Monitoring Devices

Implantable cardiac monitors detect and correct your irregular heartbeats (arrhythmias). The ICD and LINQ help if you are at risk of sudden cardiac arrest.

Your electrophysiologist places the ICD in your chest or abdomen. It uses electrical pulses to control life-threatening irregular heartbeats and requires up to three wires, called leads, which are placed in the blood vessels in your heart's cavity. They provide an electric pulse to your heart. An ICD may be used if you have survived a cardiac arrest or have a weakened heart muscle.

The newest option is the subcutaneous implantable defibrillator (S-ICD) system. Your electrophysiologist implants it just below your skin on the left side of your chest and there are no wires placed in your heart, which makes it more manageable and comfortable.

The Reveal LINQ™ ICM is a miniature wireless cardiac monitor designed to help your doctor diagnose and monitor patients who have or may have atrial fibrillation (AFib). The device is one-third the size of a AAA battery and allows your doctor to monitor your heart remotely for up to three years. It is placed just beneath your skin on the upper left side of your chest and is performed in a quick outpatient procedure that requires local anesthesia. It is similar to an injection and nearly invisible once inserted.

A cardiac resynchronization therapy (CRT), commonly referred to as a pacemaker, is used to treat heart failure. A CRT sends small electrical pulses to the lower chambers of your heart which helps them beat together and become more synchronized. This allows your heart to work more efficiently as it pumps blood and oxygen to your body. The device is a small and lightweight computer that runs on a battery that your medical team places under your skin below your collarbone. The device's leads (wires) are threaded through a blood vessel into your heart and is programmed through a computer located in your doctor's office. The device retrieves information about your heart to help your doctor treat your heart failure.

The world's smallest pacemaker, the Medtronic Micra™ does everything a traditional pacemaker does, but it is just one-tenth the size. The device, a tiny capsule less than an inch long, is implanted without invasive surgery directly into the heart wall, resulting in no scarring or evidence of the pacemaker outside the body. Approved by the FDA in April 2016, benefits of the leadless design include reducing infection risk and eliminating the issue of leads dislodging with movement, allowing you to get back to activity quicker after the procedure.