External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional
CPT4 code
Name of the Procedure:
External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional.
- Common name: 48-hour Holter monitoring
Summary
48-hour Holter monitoring is a non-invasive procedure where a portable device records your heart's electrical activity continuously for up to 48 hours. The collected data is then reviewed by a healthcare professional to detect heart abnormalities.
Purpose
This procedure helps diagnose irregular heart rhythms (arrhythmias), unexplained chest pain, dizziness, or fainting. It aims to identify abnormalities in heart function that aren't detectable in a short-term ECG.
Indications
- Irregular heartbeat/palpitations
- Unexplained chest pain
- Dizziness or lightheadedness
- Fainting episodes
- Previous heart issues requiring further monitoring
Preparation
- Wear loose-fitting clothing for easier attachment of electrodes.
- Avoid using lotions, oils, or powders on your chest before the procedure.
- Continue taking medications unless instructed otherwise by your physician.
Procedure Description
- Electrode Placement: Several small electrodes are attached to your chest with adhesive.
- Device Setup: The electrodes are connected to a portable recording device, usually worn on a belt or shoulder strap.
- Monitoring: The device records your heart's activity continuously for up to 48 hours. You will be asked to keep a diary of your activities and symptoms.
- Data Analysis: After 48 hours, the device is returned, and data is downloaded and analyzed. A report is generated and reviewed by a healthcare professional for abnormal heart rhythms.
Duration
- The monitoring itself takes up to 48 hours.
- Setup and removal take about 15-30 minutes each.
Setting
- Outpatient clinic or hospital cardiology department.
Personnel
- ECG technician (setup and removal of the device)
- Cardiologist or qualified healthcare professional (data analysis and interpretation)
Risks and Complications
- Skin irritation from adhesive electrodes.
- Minor discomfort or inconvenience from wearing the device.
- Rarely, data may be inconclusive, requiring repeat monitoring.
Benefits
- Provides a comprehensive analysis of your heart's rhythm over an extended period.
- Non-invasive and poses minimal risk.
- Can identify heart-related issues that shorter tests might miss.
Recovery
- No recovery time needed.
- Normal activities can generally be resumed immediately after the device is removed.
- Follow-up appointment may be scheduled to discuss the results.
Alternatives
- 24-hour Holter monitoring: Shorter duration, may miss less frequent abnormalities.
- Event monitoring: Worn for weeks but only records during symptoms or triggered events.
- Standard ECG: Short-term, may not capture intermittent issues.
Patient Experience
You may feel the device on your chest and around your waist, which might be slightly uncomfortable. However, you can move freely and perform most daily activities. Avoid bathing, swimming, or intense physical activities that might disrupt the device. You may feel occasional skin irritation from the electrodes.