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Cardiac event monitors

Ambulatory electrocardiography; Electrocardiography (ECG) - ambulatory; Continuous electrocardiograms (EKGs); Holter monitors; Transtelephonic event monitors

A cardiac event monitor is a device that you control to record the electrical activity of your heart (ECG). This device is about the size of a pager. It records your heart rate and rhythm.

Cardiac event monitors are used when you need long-term monitoring of symptoms that occur less than daily.

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How the Test is Performed

Each type of monitor is slightly different, but they all have sensors (called electrodes) to record your ECG. In some models, these attach to the skin on your chest using sticky patches. The sensors need good contact with your skin. Poor contact can cause poor results.

You should keep your skin free from oils, creams, and sweat (as much as possible). The technician who places the monitor will perform the following to get a good ECG recording:

You can carry or wear a cardiac event monitor up to 30 days. You carry the device in your hand, wear on your wrist, or keep it in your pocket. Event monitors can be worn for weeks or until symptoms occur.

There are several types of cardiac event monitors.

While wearing the device:

While wearing the device, you may be asked to avoid certain things that can disrupt the signal between the sensors and the monitor. These may include:

Ask the technician who attaches the device for a list of things to avoid.

How to Prepare for the Test

Tell your provider if you are allergic to any tape or other adhesives.

How the Test will Feel

This is a painless test. However, the adhesive of the electrode patches may irritate your skin. This goes away on its own once you remove the patches.

You must keep the monitor close to your body.

Why the Test is Performed

Most often, in people with frequent symptoms, a test called Holter monitoring, which lasts 1 to 2 days, will be performed before using a cardiac event monitor. The event monitor is ordered only if no diagnosis is reached. The event monitor is also used for people who have symptoms that occur less often, such as weekly to monthly.

Cardiac event monitoring may be used:

Normal Results

Normal variations in heart rate occur with activities. A normal result is no significant changes in heart rhythms or pattern.

What Abnormal Results Mean

Abnormal results may include various arrhythmias. Changes may mean that the heart is not getting enough oxygen.

It may be used to diagnose:

Risks

There are no risks associated with the test, other than possible skin irritation.

References

Krahn AD, Yee R, Skanes AC, Klein GJ. Cardiac monitoring: short- and long-term recording. In: Zipes DP, Jalife J, Stevenson WG, eds. Cardiac Electrophysiology: From Cell to Bedside. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 66.

Miller JM, Tomaselli GF, Zipes DP. Diagnosis of cardiac arrhythmias. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 35.

Tomaselli GF, Zipes DP. Approach to the patient with cardiac arrhythmias. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 32.

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Review Date: 9/24/2018  

Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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