External electrocardiographic recording for more than 48 hours up to 7 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 7 days by continuous rhythm recording and storage; scanning analysis with report Common name: Extended Holter Monitoring Technical term: Ambulatory Electrocardiography
Summary
Extended Holter Monitoring is a medical test that involves continuously recording the electrical activity of your heart for a period ranging from 48 hours to 7 days. This extended monitoring helps physicians detect irregular heart rhythms that may not be captured during a standard EKG performed in a brief office visit.
Purpose
This procedure is designed to diagnose and monitor irregular heartbeats (arrhythmias) over an extended period. The goal is to gather comprehensive data on the heart's rhythm, allowing the physician to identify abnormalities, correlate symptoms with heart rhythms, and guide treatment decisions.
Indications
- Symptoms such as palpitations, dizziness, fainting (syncope), or unexplained fatigue.
- Suspected intermittent arrhythmias that are not detected by short-term monitoring.
- Evaluating the effectiveness of medications or other treatments for arrhythmias.
Preparation
- Patients may be advised to avoid certain activities that could dislodge the monitoring equipment.
- Instructions will be given on how to keep a diary of activities and symptoms during the monitoring period.
- No fasting or special diet is usually required.
- Continue taking prescribed medications unless otherwise directed by your doctor.
Procedure Description
- Attaching the Monitor:
- Small, sticky electrodes are attached to the chest to detect heartbeats.
- The electrodes are connected to a portable recording device worn on a belt or shoulder strap.
- Monitoring Phase:
- The device continuously records heart rhythms for the prescribed duration.
- Patients go about their normal daily activities but should avoid swimming, bathing, or activities that might wet the device.
- Event Diary:
- Patients are asked to log any symptoms experienced and their corresponding times.
- Data Retrieval and Analysis:
- After the monitoring period, patients return the device to the healthcare provider.
- The recorded data is analyzed through advanced scanning technology and a detailed report is generated.
Duration
The monitoring period lasts from more than 48 hours up to 7 days, depending on the individual case.
Setting
This procedure is primarily conducted on an outpatient basis, either at a hospital or an outpatient clinic.
Personnel
- Cardiologist or trained healthcare technician to attach the monitoring device and explain procedures.
- Cardiac electrophysiologist or specialized personnel to analyze the recorded data and produce the report.
Risks and Complications
- Skin irritation where the electrodes are attached.
- Discomfort or inconvenience of wearing the device for an extended period.
- Device malfunction or incomplete data recording (rare).
Benefits
- Comprehensive data collection for accurate diagnosis of heart rhythm abnormalities.
- Enhanced ability to correlate heart activity with patient symptoms.
- Better-informed treatment plans and potentially more effective management of arrhythmias.
- Insights into treatment efficacy if the patient is under treatment for arrhythmias.
Recovery
- No recovery time is typically needed since this is a non-invasive monitoring procedure.
- Patients can resume normal activities immediately after the device is removed.
- Follow-up appointments may be scheduled to discuss the results and next steps.
Alternatives
- Standard 24-hour Holter monitoring (shorter duration, potentially less comprehensive).
- Event monitoring (activated by the patient when symptoms are experienced, which may miss unperceived arrhythmias).
- Implantable loop recorder (more invasive but allows long-term continuous monitoring).
Patient Experience
- The procedure is generally well-tolerated with minor skin irritation being the most common issue.
- Some patients may feel self-conscious or inconvenienced by wearing the device for an extended period.
- Pain management is typically not necessary, and comfort measures include wearing loose clothing and following care instructions for the device.