Dynamic holter ECG
When is this exam indicated?
Holter monitoring is prescribed and used to primarily assess heart rhythm disorders (cardiac arrhythmias). More recently, through more sophisticated analysis programs, Holter monitoring has also been used for the study of more specific problems, such as the presence of QT interval prolongation, appearance of Brugada patterns, presence of intermittent ventricular arrhythmias (WPW), silent ischemia, and dysfunctions of the autonomic nervous system.
Among the cardiac arrhythmias that can be most frequently recorded through Holter ECG monitoring are supraventricular and ventricular extrasystoles, atrial fibrillation or flutter, paroxysmal supraventricular tachycardias, unsustained ventricular tachycardias, bradyarrhythmias and atrioventricular blocks. Arrhythmias may be asymptomatic or symptomatic, i.e. associated with disorders reported by the patient.
How is it performed?
The Holter ECG records electrical signals through adhesive electrodes placed on the chest. The electrodes are connected through cables to the recorder. At the end of the recording, the recorded data is downloaded to the central system and analyzed through a program that automatically carries out a first analysis, and highlights the arrhythmias that deserve a specific evaluation by the doctor who reports the examination.
Currently, so-called “wireless” systems are also available, used mainly in extended Holter recordings, which do not use adhesive electrodes, but instead use electrodes inserted in a corset (vest) or belt system, which the patient can put on and take off independently (for example to bathe).
Holter monitoring does not require therapy or activity restrictions: on the contrary, it is important to live a life as active as possible during the Holter registration, and possibly to carry out activities associated with the onset of the symptoms being studied. It is important to note any symptoms and changes in activity in the appropriate notebook (diary) in order to relate the symptoms to any rhythm disturbances.