Do you sometimes feel like your chest is pounding, your heart is racing, or your heart is beating very fast? But when you go to the doctor and get an ECG, the report says that there is nothing wrong, that everything is normal. It is at times like these that a doctor tells you about a small machine that you can take home and use for a few days. Today we are talking about this device called an ambulatory monitor, which monitors your heart rhythm over a long period of time.
Simply put, what is an ambulatory monitor?
It's very simple. It's a small device that you can take home and wear. It's like a small phone. It records the electrical activity of your heart continuously for a day, two, a week, or even longer.
Think of it this way: an ECG (electrocardiogram) taken at the hospital is like a snapshot of your heart at that moment. But this ambulatory monitor is like a video taken over several days. This is very important for catching occasional, hard-to-detect changes in heart rhythm.
Why do we need this kind of test?
The main reason is to find out exactly what the irregular heartbeats are, that is, arrhythmias . Some arrhythmias occur only occasionally. They may not occur when you are at the doctor's. Then a regular `ECG` cannot catch them.
With this monitor,
- It can even detect heart rhythm irregularities that you may not be aware of .
- You can accurately record the problems that come and go from time to time.
- You can see how your heart works in different situations, such as while you're sleeping, working, or exercising.
There are several types of arrhythmias that are commonly seen.
| Type of arrhythmia | Simply put... |
|---|---|
| Bradyarrhythmias | The heart rate drops abnormally. It feels like it's pounding. |
| Tachyarrhythmias | An abnormally high heart rate. The chest is pounding, and it feels like it's about to burst. |
| Supraventricular arrhythmias | This is an irregular rhythm that occurs in the two upper chambers of the heart (atria). |
| Ventricular arrhythmias | This is an irregular rhythm that occurs in the two lower chambers of the heart (ventricles). |
A cardiologist or electrophysiologist will analyze the data from this test and determine exactly what your condition is.
How does this monitor work?
Our heart has its own electrical system. The four chambers of the heart contract in an orderly, rhythmic manner and pump blood because of signals from this electrical system.
These electrical signals are strong enough to reach the surface of our skin. So, a few little sensors, called electrodes , that you put on your chest can pick up these signals. These sensors are connected to a little monitor with wires. The monitor records all of these signals.
If there is a change in the functioning of a certain part of the heart, there is also a change in the electrical signals coming from there. It is by looking at those changes that a doctor can understand what the problem is with your heart.
Are there different types of these monitors?
Yes, depending on the nature of your symptoms, your doctor will choose the type of monitor that is most suitable for you. Let's take a look at the main types.
| Monitor type | What happens in that? |
|---|---|
| Holter monitors | This is usually worn for 24 to 48 hours (a day or two). Sometimes it can be worn for a week or two. During this time, every heartbeat is continuously recorded. |
| Event monitors | This is only recorded when there is a suspicion of an abnormality. When you feel symptoms (e.g., chest pain), you can press a button on this device to record them. Some devices automatically detect and record an abnormality. |
| Real-time monitors | This is similar to an event monitor, but the special thing is that as soon as an anomaly is recorded, the data is immediately sent to a monitoring center. This is very important for people with serious conditions. |
| Patch recorders | This is a small device that you can stick on your chest like a plaster. There are no wires. You can wear it for about two weeks at a time. It's very convenient. |
| Implantable loop recorders | This is a very small device. It is implanted under the skin of your chest with a minor surgery. It can be left in place for two to three years. There is no problem when bathing or swimming. This is very useful for people who rarely experience symptoms. |
What happens before the test and on the day of the test?
Preparing before the test
Your doctor will choose the type of monitor that is right for you and explain it to you.
- It's a good idea to take a good shower before putting on the monitor, as some types of monitors may prevent you from taking a shower for a day or two.
- Most importantly: Do not apply any type of oil, cream, or lotion to the skin of your chest. Doing so will prevent the sensors (electrodes) from adhering properly to the skin and the signals from being recorded properly.
- Wear clothes that are easy to put on and take off.
On the day the monitor was installed
A member of the medical staff (such as a technician) will explain these things to you:
- How to use the device, how to operate it.
- If you need to remove and reinsert the sensor, like when bathing, here's how to do it.
- It tells you about things that you should not approach because they may interfere with the monitor (e.g. magnets, some electronic devices).
- The areas where the sensor will be attached are cleaned with alcohol and, if necessary, any hair is removed. This ensures that the sensor is attached properly and the signals are recorded clearly.
Are there any risks in using this equipment?
These tests are very safe. They are not painful. However, minor side effects may occur.
- For external monitors: The most common side effect is redness and itching where the sensor is applied. Some people may be sensitive to the adhesive used to attach the sensor. If you have any allergies, tell your doctor in advance. This usually goes away within a few days after the sensor is removed.
- For implantable recorders: The potential complications are very low.
- There may be some pain or discomfort where the device was inserted. This usually resolves on its own.
- Very rarely, the wound can become infected. This is treated with antibiotics.
- It is also very rare to have an allergy to something contained in the device.
- Sometimes the heart signals may not be received clearly where the device is located, and then it may have to be moved to another location.
What happens after receiving the test report?
After you return the monitor to the hospital, the data from it is downloaded and sent to the specialist. The doctor carefully examines all of that data and comes to a conclusion about your medical condition.
After that, the hospital will call you and explain the results. If necessary, they will also inform you about what to do next, what treatments to start, or if you need to see another specialist.
What time should I call my doctor?
They will tell you in advance who to call and what number to call if you have any problems with the device.
Especially if you have an implantable loop recorder , tell your doctor or hospital immediately if you have any of the following symptoms. These may be signs of an infection.
- If you feel feverish or have a cold.
- If you feel warmth when you touch the skin around the insertion site.
- If the area is swollen or red.
- If a fluid such as pus or blood is draining from the wound.
The time it takes to get the test results may vary depending on the type of monitor, the time of the test, and the hospital's workload. You can ask the staff about this on the day of your monitor placement.
Take-Home Message
- An ambulatory monitor is a small, safe, wearable device that monitors your heart rhythm over several days.
- This is very important for detecting occasional heart rhythm irregularities that are not picked up by a normal ECG.
- Follow your doctor's instructions exactly. Be careful about how you use the device and what you should avoid.
- The most common side effect is mild itching and redness of the skin where the sensor is attached.
- If you have any concerns about the device or if you have signs of infection from a device implanted under the skin, seek medical advice immediately.
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