External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; 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; review and interpretation by a physician or other qualified health care professional. Common name(s): Holter monitor, 48-hour ECG recording
Summary
A Holter monitor is a portable device for continuously tracking the electrical activity of your heart for up to 48 hours. The data collected is analyzed by a healthcare professional to diagnose and manage heart rhythm problems.
Purpose
The primary purpose is to detect irregular heartbeats (arrhythmias) and to monitor the heart's activity over an extended period. Goals include identifying and diagnosing arrhythmias, evaluating the effectiveness of heart medications, and assessing the heart's response to everyday activities.
Indications
This procedure may be indicated for patients experiencing unexplained fainting (syncope), dizziness, palpitations, or chest pain. It is also useful for those with known heart conditions, such as atrial fibrillation or to monitor the effectiveness of heart medications.
Preparation
Patients may need to avoid certain medications that can affect heart rhythm, as instructed by their doctor. Wearing comfortable, loose-fitting clothing is recommended. No fasting or special tests are generally required beforehand.
Procedure Description
- Small electrodes are attached to the chest with adhesive pads.
- Wires connect the electrodes to a portable Holter monitor.
- The monitor records heart activity continuously for up to 48 hours.
- Patients maintain a diary of their activities and any symptoms experienced.
- After 48 hours, the monitor is returned to the healthcare provider for data retrieval and analysis.
Duration
The procedure involves wearing the monitor for up to 48 hours.
Setting
Typically performed in an outpatient clinic or a physician’s office.
Personnel
A nurse or technician attaches the electrodes and provides instructions. A physician or other qualified health care professional reviews and interprets the results.
Risks and Complications
Very low-risk procedure, but some may experience skin irritation from the adhesive pads. There are no significant complications to be concerned about.
Benefits
The procedure aids in accurately diagnosing heart rhythm abnormalities and tailoring appropriate treatment. Results can lead to early intervention and better management of heart conditions.
Recovery
No specific recovery period required. Patients can resume normal activities, except avoiding getting the monitor wet. Follow-up appointments may be necessary to discuss results and plan further treatment if needed.
Alternatives
Alternatives include event monitors, which are worn longer but only record at certain times, and implantable loop recorders for long-term monitoring. Each has pros and cons regarding duration of monitoring and invasiveness.
Patient Experience
Patients may feel the electrodes being attached but generally do not experience any pain. Discomfort may arise from wearing the device, but it is typically minor. Normal activities can continue aside from bathing and swimming.