Perhaps the only thing worse than spending the day in the emergency room is the follow-up care which is sometimes required.
Heart patients, particularly those with suspected arrhythmias or other heart conditions which are difficult to diagnose, often find that an initial diagnosis can’t be determined in an emergency room.
Time-consuming, and somewhat cumbersome, follow-up treatment is sometimes required.
When a diagnosis can’t be determined, a suspected arrhythmia patient may be asked to wear a Holter monitor to help physicians confirm or make a definitive diagnosis.
Used since the 1960s, the Holter monitor is a medical device which is used to monitor how the heart responds during normal activity.
It’s often used to help diagnose conditions such fainting spells, atrial flutters, slow heart beat, heart palpitations, ventricular tachycardia, multifocal atrial tachycardia, and paroxysmal supraventricular tachycardia.
Sometimes, Holter monitors are worn to monitor heart rhythms after a heart attack or when new heart medications are prescribed.
While wearing a Holter monitor is painless, it can be somewhat intrusive and may interfere with daily activities such as showering or sleeping. This is because the heart patient is connected to the Holter monitor through electrodes which are attached to the chest of the heart patient.
The battery-operated Holter monitor is then worn in a bag either around the neck or waist of the patient. Holter monitors are generally worn from 24 to 48 hours at which time the patient returns to the physician to have the electrodes removed and the results read.
Patients must also keep a log of symptoms while the monitor is worn so that the physician can match the symptoms to the monitor results.
Researchers at Scripps Health believe that a new digital device, the Zio Patch, may be a viable -- and more patient-friendly -- alternative to the Holter monitor.
The Zio Patch is a single-use ambulatory, digital device that can be worn up to 14 days, enabling a longer monitoring period. Unlike the Holter monitor, there are no batteries and electrodes involved and no bags which the patient must wear.
The Zio Patch monitor is applied using a small adhesive bandage -- approximately two by five inches -- to the patient’s chest. The adhesive bandage holds the monitor in place where it monitors heart rhythms on a continuous basis.
Patients are able to continue normal activities such as exercise and showering while wearing the Zio Patch. At the end of the monitoring period, the patient simply removes the Zio Patch and returns it in a pre-paid envelope.
As a part of the study, researchers followed 285 emergency room patients from various locations throughout the United States. Participating hospitals included Stanford Hospital, Scott and White Memorial Hospital in Temple, Texas, and Scripps Memorial Hospital La Jolla, in California.
All study participants presented at the emergency room with symptoms indicating a possible arrhythmia. Participants were fitted with a Zio Patch and sent home.
At the end of the 14-day monitoring period, participants removed the Zio Patch and returned it via pre-paid mail to iRhythm Technologies, Inc. iRhythm then analyzed the results and returned the findings to the patient’s physician.
Researchers found that the majority of the study participants -- 59 percent -- did not have an arrhythmia. In fact, one participant was found to have a serious life-threatening irregular heart rhythm and received follow-up care and treatment.
There is currently no data available indicating whether the Zio Patch is more effective than the Holter monitor in gathering heart rhythm data. Another study is planned to compare side-by-side data between the Holter monitor and the Zio Patch.
Results should be available in late 2012. Researchers are hopeful that the digital Zio Patch will provide medical professionals with an effective, more patient-friendly alternative to the Holter monitor.
The Scripps Health study results were presented by Dr. Steven Higgins, electrophysiologist for Scripps Health, at the Heart Rhythm Society’s 33rd Annual Scientific Session in Boston in early May, 2012.
Scripps Health (2012, May 11). Novel new device diagnoses irregular heartbeat: Small stick-on device monitors heart rhythm for weeks. ScienceDaily. Retrieved May 19, 2012, from http://www.sciencedaily.com/releases/2012/05/120511175001.htm
Issam Mikati, M.D. Holter monitor (24h). MedLine Plus, a service of the US National Library of Medicine National Institute of Health. 01 Jun 2010. Retrieved May 19, 2012, from http://www.nlm.nih.gov/medlineplus/ency/article/003877.htm
Reviewed May 21, 2012
by Michele Blacksberg RN
Edited by Jody Smith