Holter monitor
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Holter monitor | |
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Specialty | Cardiology, electrophysiology |
In
The Holter's most common use is for monitoring ECG heart activity (electrocardiography or ECG). Its extended recording period is sometimes useful for observing occasional cardiac arrhythmias which would be difficult to identify in a shorter period. For patients having more transient symptoms, a cardiac event monitor which can be worn for a month or more can be used.[1]
When used to study the heart, much like standard electrocardiography, the Holter monitor records electrical signals from the heart via a series of
History
The Holter monitor was developed at the Holter Research Laboratory in Helena, Montana, USA by experimental physicists Norman J. Holter and Bill Glasscock,[3][4] who started work on radio telemetry in 1949. Inspired by a suggestion from cardiologist Paul Dudley White in the early 1950s, they redirected their efforts toward development of a wearable cardiac monitoring device.[5] The Holter monitor was released for commercial production in 1962.[5]
Data storage
Older monitors used
Components
Each Holter system has hardware (called monitor or recorder) for recording the signal, and software for review and analysis of the record. There may be a "patient button" on the front that the patient can press at specific instants such as on sickness, going to bed, taking pills, etc.; this records a mark that identifies the time of the action on the recording. Advanced Holter recorders are able to display the signal, useful for checking the signal quality.
Recorder
The size of the recorder differs depending on the manufacturer of the device. The average dimensions of today's Holter monitors are about 110x70x30 mm, but some are only 61x46x20 mm and weigh 99 g.[6]
Most Holter monitors the ECG via two or three channels. Depending on manufacturer, different lead systems and numbers of leads are used; the number of leads may be minimised for patient comfort. Two or three channel recording has been used for a long time in the Holter monitoring history; 12-channel Holters were introduced later, using either the standard 12-lead electrocardiograph or the modified (Mason-Likar)
Another innovation is the inclusion of a triaxial movement sensor, which records the patient's physical activity and, on examination and software processing, extracts three movement statuses: sleeping, standing, or walking. Some modern devices can record spoken patient diary entries that can be listened to.
Analyzing software
After the recording of ECG signal for typically 24 hours, the signal must be analysed. A person would have to listen for the full 24 hours; instead integrated automatic analysis determines different sorts of heart beats, rhythms, etc. The success of the analysis is closely associated with the signal quality, which mainly depends upon the attachment of the electrodes to the patient's body. Incorrect attachment allows electromagnetic disturbance to add noise to the record, particularly with rapid patient movement, impeding processing. Other factors can also affect signal quality, such as muscle tremors, sampling rate and resolution of the digitized signal (high quality devices offer higher sampling frequency).
The automatic analysis commonly provides the physician with information about heart beat morphology, beat interval measurement,
Gallery
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A 5-lead placement EASI configuration Holter monitor
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A Holter monitor can be worn for many days without causing significant discomfort.
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Canine Holter monitor with DogLeggs Vest
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A Holter monitor with a US quarter dollar coin to show scale
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Holter monitor can be worn with bra, with no discomfort.
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Holter monitoring of blood pressure
See also
- Wireless ambulatory ECG
- BodyKom, a heart monitoring service transmitting data via the mobile cellular telephone network
References
- ^ "Holter Monitor". www.heart.org. Archived from the original on 16 July 2018. Retrieved 8 April 2018.
{{cite web}}
: CS1 maint: bot: original URL status unknown (link) - . Epub 2013 Jun 19. 12-lead Holter electrocardiography. Review of the literature and clinical application update. Su L1, Borov S, Zrenner B.
- ^ Meldrum, Stuart J (1993). "Obituary for Wilford "Bill" Glasscock". Journal of Ambulatory Monitoring. 6 (3): 243.
with the passing of Bill Glasscock, we have lost the second half of one of the most successful partnerships ever to exist in the field of biomedical engineering
- ^ "At the Heart of the Invention: The development of the Holter Monitor". National Museum of American History. 2011-11-16. Retrieved 13 August 2016.
- ^ PMID 18956161. Retrieved 4 August 2009.
- ^ HeartBug technical specifications Archived 2013-10-04 at the Wayback Machine
- PMID 3653124.
External links
- Holter monitor – MedLine Plus
- Holter monitor – Biocalculus Archived 2022-02-15 at the Wayback Machine