- Patient-activated monitor: worn for 5-7 days , to allow patient to manually initiate recording of heart activity when he experiences symptoms
- To detect cardiac arrythmias
- To evaluate chest pain
- To evaluate the effectiveness of antiarrhythmic drug therapy.
- To monitor pacemaker function
- To correlate symptoms and palpitations with actual cardiac events and patient activities.
- To detect sporadic arrhythmias missed by an exercise or resting electrocardiogram (ECG)
- Also known as ambulatory ECG or dynamic monitoring.
- Make sure the patient has signed an appropriate consent form
- Note and report allergies.
- Provide bathing instructions because some equipment must not get wet.
- Instruct the patient to avoid magnets, metal detectors, high-voltage areas and electric blankets.
- Explain the importance of keeping a log of daily activities as well as emotional upsets, physical symptoms, and ingestion of medication.
- Explain how to mark the tape at the onset of symptoms, if applicable.
- Explain how to check the recorded to make sure that it's working properly.
- Electrodes are applied to the chest wall and securely attached to the lead wires and monitor.
- Placing electrodes over large muscles masses, such as the pectorals, is avoided to limit artifact.
- A new or fully charged battery is inserted in the recorder.
- A tape is inserted and the recorder is turned on.
- The electrode attachment circuit is tested by connecting the recorder to a standard ECG machine, noting artifact during normal patient movement.
- Remove all chest electrodes
- Clean the electrode sites
- Check for skin sensitivity to the electrodes.
- No significant arrythmias or ST-segment changes on ECG.
- Changes in heart rate during various activities
- Abnormalities in cardiac rate or rhythm suggesting serious symptomatic or asymptomatic arrythmias.
- ST-T wave changes coinciding with patient symptoms or increased patient activity and suggesting myocardial ischemia.