Senior woman at the doctor’s office for chest pain, requires diagnoses through a heart monitor.

What is a heart monitor?

Everything you need to know

February 07, 2018 | BY BIOTRICITY

If you have experienced any sort of heart attack symptoms, like chest pain or shortness of breath, if you’ve had a stroke, or if you suffer from suspected heart problems or arrhythmias which are electrical disturbances in the heart which can cause the heart to beat abnormally (such as the very common atrial fibrillation), chances are your doctor has suggested heart monitoring through electrocardiography. Heart monitors are used to take a closer look at how the electrical system in your heart is working and determine if there is a problem. There are several forms of heart monitoring; monitoring can occur either inside or outside of the doctor’s office depending on the type of monitor used. Patients who have potentially life-threatening arrhythmias should be actively monitored as directed by their physician.

Traditionally, a patient with a potential arrhythmia may be hooked up in the physician’s office or hospital to an ECG machine. An ECG, or 12-lead as it is often referred, is a great first step in the identification of arrhythmias.  It provides a snapshot of what is happening electrically in the patient’s heart at that exact moment. Unfortunately, an ECG only last 10-30 seconds and will only uncover electrical issues that are permanent or happening at that instant. Many patients suffer their arrhythmias during their everyday lives, at home or work, and require a more long-term, portable type of monitoring.

If the arrhythmia is not present during the ECG, an ambulatory monitor is often prescribed.  Ambulatory monitoring is done with a small device that a patient can wear at home or work while engaging in their normal daily activities. This allows a doctor to observe how their patient’s heart is functioning over an extended period in order to diagnose conditions related to irregular cardiac rhythms. Here is a chart of the kinds of ambulatory monitors available today.

Kinds of heart monitors:
  • Holter/ Patch Holter: A portable, external monitor that includes cables and electrode patches that attach directly to the skin. It continuously records 1-3 unique views of the heart’s electrical activity for 1-2 days. Recently, Holter monitors may come in the form of a patch Holter, which looks like a large adhesive bandage that is placed on the chest. A Patch Holter normally records a single channel of ECG for up to 14 days. Holter monitors are only a recording device.  The device must be returned and analyzed in order to identify any abnormalities.
  • Event Recorder: Portable and external like a Holter, it too includes cables and patches that attach to the skin. However, while this device is constantly monitoring the patient’s ECG, it only makes a recording if the patient indicates they are having a symptom. These events normally capture 1-2 minutes of ECG data. They can be worn for up to 30 days and require the patient to transmit their recordings to a certified call center for analysis and reporting.
  • Implantable Monitor: This monitor is a small, usually cylindrical device, that is implanted just under the skin. It doesn’t capture all heart activity, but it does automatically detect and record abnormal heart rhythms for up to 3 years.  These abnormal rhythms can be transmitted remotely or in a physician’s office. It is often used for patients who experience rare fainting episodes.
  • Mobile Cardiac Telemetry (MCT): A wearable external monitor the records all heart activity for up to 30 days and continuously detects and automatically transmits all patient indicated or auto-detected heart abnormalities through a cellular transmission.
Which one is better?

Recent research suggests that constant remote cardiac monitoring is preferable because it resulted in identifying reported episodes of unexplained syncope, arrhythmic episodes, and cryptogenic stroke that patients did not record on self-reporting monitors. That leaves the Holter monitor, implantable monitors, and MCT devices. While Holters are the traditional technology of choice, they are normally limited to a 48-hour monitoring period, they are viewed as cumbersome, and their data must be analyzed after the device is returned to the physician. Implantable devices monitor for abnormal heart rhythms for up to three years. These devices can be invasive, requiring a minor surgery to implant, and they do not record all cardiac activity during their study period. This leaves MCT devices, like our own Bioflux. MCT devices are generally quite small and portable, and their capability to actively monitor and automatically transmit ECG data to a monitoring network for interpretation makes them highly effective for time efficient diagnoses. In addition, MCT devices allow for a more holistic picture of a patient’s heart health because they offer constant monitoring and analysis of cardiac activity for up to a 30-day period, during which the patient resumes normal daily activities.

Mobile cardiac telemetry

MCT monitoring offers physicians and patients a convenient and flexible way to monitor and detect arrhythmias. Constant connectivity allows MCT solutions to collect data in real-time, that data is then uploaded and analyzed, which enables faster diagnosis because the data analysis occurs in parallel to the MCT testing. In more traditional cardiac monitors, like Holter monitoring, the test occurs and then the physician and patient wait for report analysis after the device has been returned to the office. Furthermore, it has been shown that longer term monitoring yields results. Arrhythmias are notoriously difficult to detect because they can be erratic and/or intermittent; cardiac monitoring over a longer period of time has proven more effective in helping to diagnose arrhythmias like atrial fibrillation. MCT is also empowering for patients because they can resume normal activities throughout the monitoring period. If a patient requires long term ambulatory monitoring, MCT’s real-time data collection and auto-detection capabilities can potentially reduce risk by automatically transmitting data, facilitating faster diagnosis, speeding up the care process, and transmitting data which facilitates a faster diagnosis and treatment plan.