External electrocardiographic recording for more than 48 hours up to 21 days by continuous rhythm recording and storage; scanning analysis with report
CPT4 code
Name of the Procedure:
External Electrocardiographic Recording for More Than 48 Hours Up to 21 Days by Continuous Rhythm Recording and Storage (Holter Monitoring)
Summary
Holter monitoring is a procedure where a portable device continuously records the heart's electrical activity over an extended period—up to 21 days. It helps detect irregular heart rhythms that may not be captured during a standard ECG test.
Purpose
Holter monitoring addresses issues related to irregular heartbeats or arrhythmias. The goal is to provide a detailed and long-term record of heart activity to diagnose or rule out heart conditions.
Indications
- Symptoms such as palpitations, dizziness, unexplained fainting, or chest pain
- Existing conditions like atrial fibrillation, heart palpitations, or other forms of arrhythmia
- Monitoring the effectiveness of heart medications
Preparation
- No fasting required, but avoid caffeine and large meals before the procedure
- Wear comfortable clothing; you may be asked to remove jewelry or accessories
- Inform your doctor about any medications you are taking
Procedure Description
- Electrode Placement: Small electrodes are placed on your chest.
- Connecting Device: Electrodes are connected to a portable Holter monitor, which you will carry in a pocket or a pouch around your neck.
- Continuous Monitoring: The device records your heart's electrical activity continuously for 48 hours up to 21 days.
- Diary: You may be asked to keep a diary of your activities and symptoms.
- Data Retrieval: After the monitoring period, you return the device, and the recorded data is analyzed using specialized software.
Tools and Equipment: Electrodes, Holter monitor device, analysis software.
Anesthesia: None required.
Duration
The monitoring is continuous, ranging from 48 hours up to 21 days.
Setting
The device is set up in an outpatient clinic, but you wear it during your daily activities at home, work, or elsewhere.
Personnel
- Cardiologist or Electrophysiologist
- Trained Nurse or Technician
Risks and Complications
- Mild skin irritation at the electrode sites
- Very rare possibility of allergic reaction to adhesive
Benefits
- Detailed assessment of heart activity over a longer period
- Helps diagnose arrhythmias that are intermittent and not captured on a standard ECG
- Allows for better-informed treatment decisions
Recovery
- Resume normal activities immediately after electrode placement.
- Follow any specific instructions for returning the device.
- No special recovery requirements as the procedure is non-invasive.
Alternatives
- Standard ECG: Short-term recording, less comprehensive.
- Implantable Loop Recorder: Longer-term monitoring, more invasive.
- Event Monitor: Activated by the patient during symptoms but records less data.
Patient Experience
- Generally comfortable, though you might feel mild discomfort from the electrodes.
- Continued normal activities with minimal restrictions.
- Promptly report any significant discomfort or technical issues with the device.
- Pain management is typically not needed, but the clinic will provide comfort measures if necessary.