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Ambulatory Electrocardiogram

How It Is Done

Continuous recorders

Continuous recorders are the most common type of ambulatory electrocardiogram monitor. This type includes the Holter monitor camera.gif.

A continuous recorder provides a 24- to 72-hour record of the electrical signals from your heart. A standard EKG monitors only 40 to 50 heartbeats during the brief period you are attached to the machine. A continuous recorder monitors about 100,000 heartbeats in 24 hours and is likely to find any heart problems that happen with activity.

For this test, you wear a lightweight, battery-operated tape recorder (monitor) on a strap over your shoulder or around your waist. The recorder is connected by wires to small metal discs (electrodes) taped to your chest. The electrodes detect the electrical signals from your heart. A clock is connected to the recorder so you can note what time it is when you have any symptoms.

You will be fitted with the recorder and electrodes by a technician in a doctor's office or hospital room.

  • Several areas on your chest may be shaved and cleaned, and then a small amount of electrode paste or gel will be applied to those areas.
  • The electrode pads will then be attached to the skin of your chest, with thin wires connecting the electrodes to the monitor.
  • You may be hooked up briefly to a standard EKG machine to ensure that the electrodes are working properly.
What you do during the test

While wearing the continuous recorder, you will also be asked to keep a diary of all your activities and symptoms, including the type of activity you were doing and the time your symptoms started. In the diary, write down the exact times when you exercise, climb stairs, eat, urinate, have a bowel movement, have sex, sleep, get emotionally upset, take medicine, or perform other activities. If you have any symptoms of heart problems, such as dizziness, fainting, chest pain, or palpitations, push the event-marker button on the recorder to mark it and write down the exact time and how long the symptom lasts. For example, you might write: "12:30 p.m. Ate lunch. 1:00 p.m. Argument with boss, had chest tightness for several minutes."

When you sleep, try to stay on your back with the recorder carefully positioned at your side so that the electrodes are not pulled off. If one of the electrodes or lead wires comes loose, a light on the monitor will flash. Press on the center of each electrode to see if you can restore the contact. Call your doctor if one of the electrodes comes off and you can't get it to stay on.

While you are wearing a monitor, try to stay away from magnets, metal detectors, high-voltage areas, garage door openers, microwave ovens, and electric blankets. Do not use an electric toothbrush or shaver. Signals from these types of electronic equipment can sometimes interfere with the recording.

What you and your doctor do after the test

WebMD Medical Reference from Healthwise

Last Updated: December 09, 2011
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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