Heart Rhythm Problems
Heart Conditions
Heart Rhythm Problems
If you or your health care team thinks you might have an irregular heartbeat (an arrhythmia), they may suggest that you use a heart monitor at home to collect information about your heart’s activity. These devices are helpful because they provide more monitoring than is possible with a standard electrocardiogram (ECG) in your doctor’s office.Using a heart monitor can help find or rule out a heart rhythm problem. It also will guide treatment, if needed.
There are a variety of heart rhythm monitors to record how your heart is beating and to pick up on any irregular heart rhythms or patterns while you are at home, work or play. You can wear some devices. In rarer cases, others can be inserted under your skin near the heart.
Use this resource to learn more about heart rhythm monitors, what types there are, when to use them, and what to expect after the test.
Your heart rhythm is controlled by electrical signals. An arrhythmia happens if there is a misstep in the heart’s usual rhythm. Some examples include:
• Atrial fibrillation – a rapid heartbeat that is also very erratic; it can cause the blood to pool and clot in the heart, increasing the risk of stroke
• Tachycardia – heart rhythms that are too fast; for example supraventricular tachycardia or ventricular tachycardia
• Bradycardia – heart rhythms that are too slow
A normal resting heart rate is usually between 60-100 beats per minute and can vary throughout the day and with activity.
Questions to Ask Your Doctor
You may have questions about heart rhythm monitoring, why it is being recommended, and what the information tells you. It may be helpful to write down a list of questions ahead of time. Below are some common questions many patients have:
- Why are you recommending this type of heart monitor over others?
- How will wearing it affect my regular activities at work, caring for my family, being active, or bathing?
- How will the monitor measure my heart rate and rhythm?
- Do I need to press a button or do anything when I have symptoms or does the device automatically record what’s happening with my heart?
- How do I know if the monitor is working?
- Would longer monitoring give us more useful information about my condition?
- How accurate is this type of monitoring? Are there any limitations?
- What are the downsides if we don’t do any monitoring?
- Should I also keep a log of when I feel symptoms and what I was doing at the time? What symptoms are you most interested in knowing about?
- Do I need to avoid magnets or other things that can disrupt the signal between the sensors and the device?
- I’ve heard some monitors that stick to the chest can irritate the skin. What can I do about it?
- What do my results mean?
- Are my palpitations serious or should I try to ignore them? Will I need ongoing monitoring?
- Will my insurance cover monitoring?
- Should I consider using or getting a device that can record an ECG (a smartwatch or other device) more regularly?
- Is there value in using my smartphone or watch to monitor my heart rhythm or heart rate?
Types of Heart Monitors
There are many different types of heart rhythm monitors. Each one is battery-operated and equipped with special sensors that can detect and record the ups and downs of the heart’s rhythm.Heart monitors usually vary based on:
- How long they are worn and record the heart’s activity. Some are worn for just a few days, while others will monitor heart activity for a few weeks or even longer.
- How the information is captured. For example, if the wearer needs to take some sort of action to start a recording when symptoms occur or if the device continually collects data on its own. With some devices, if you press a button or do something to trigger a recording, it will save information from about 45 seconds before and a little while after the event. This helps to see whether there is a relationship between symptoms and how your heart is beating.
- Whether the data is:
This is sometimes called “record now, analyze now” or “record now, analyze later.” Ask your care team which approach is best for you.- Sent in real-time for review and to notify your care team if a worrisome arrhythmia is found.
- Analyzed later once the device is sent back or returned after wearing it.
Devices that might be prescribed
DeviceHow or where it’s wornHow long it’s usually worn or usedThings to keep in mind/ask about Holter monitorAround your neck with a strap so that it rests near the middle of your chest or on your belt1-3 days (up to 2 weeks for newer models)- Short-term monitor, best option if symptoms happen most days
- About the size of a deck of cards
- Need to avoid getting it wet or showering unless you have a waterproof cover
- Data is reviewed after wearing it
Similar to a Holter monitor, but for longer.Event monitors have sensors that attach to your chest using sticky adhesive; wires connect these sensors to a handheld monitor that you can put in your pocket or on your belt. Some types attach to your wrist.
Patch recorders are placed on the skin of your chest with sticky adhesive; they are usually small enough to be hidden under clothing and not have visible wires or leads; these wires are usually built into the device.2-6 weeks, depending on the device selected
- Longer-term monitor, best if symptoms are not felt or if they happen only every once in a while
- Many ask the wearer to push a button when symptoms occur to record and store heart’s electrical activity around that time; others send the information in real-time to a company that then sorts though the data and reports to the doctor
- Patch recorders may be easier to manage. You should be able to shower (once it is in place), exercise and sleep comfortably given its small size. These may only record activity for up to 14 days.
- Often considered to monitor symptoms
- Automatically records and sends data to a base monitor and it is sent to technicians who monitor ECG; you can also record a symptom by touching a button on the monitor
- A good Internet connection is important to transmit the data
- Keep the base monitor within 30 feet of your sensor
- You will need to replace patches every 5 days
Inserted just under the skin near the heart through a small incision
Up to 4 years- About the size of large paperclip
- Very simple to place on an outpatient basis without sedation; patients can drive themselves home after
- Records all the time
- Sends data from a home monitoring system through a secure website to a central monitoring station
- Can be easily removed if needed
No matter what device is used, it’s helpful to write down any symptoms you have and when so your care team can see if they match up to any abnormal heartbeats or rhythms that are found. Not everyone has or notices symptoms, but some common ones include:
- Palpitations (your heart feels like it is flip-flopping, skipping beats, or racing)
- Shortness of breath
- Feeling lightheaded or dizzy
- Unexplained fainting spells
- Chest pain, discomfort or pressure
- Being overly tired
For devices that are placed on your chest, the area of the skin will be cleaned and prepped to be sure the sensors attach well and have good contact to record your heart activity. For men, chest hair in that area may need to be shaved off.
Choosing a Heart Monitor
There are a number of factors that come into play when selecting which heart monitor is best for you, if one is needed. The choice mostly comes down to how often you have symptoms if you do.For example, if you feel your heart start to race, flip flop or skip beats nearly every day, wearing a Holter monitor for 2-3 days is the way to go.
If, however, your symptoms only happen every once in a while (let’s say weekly or monthly), wearing a Holter monitor for just a few days could miss a heart rhythm issue, if there is one. In this case, wearing an event monitor or a patch recorder for a longer period of time is the better choice.
Longer monitoring may also be the best option for people who don’t have symptoms, but an arrhythmia is suspected.
Other things to think about and talk with your care team about:
- Whether you need real-time monitoring where the data is collected and sent to a central place where someone looks at it and sends a report to your care team. Other devices record your heart’s activity, but the information is reviewed after you send the monitor back. If you have a loop monitor inserted, it will monitor your heart around-the-clock without you needing to do anything.
- How involved you’d like to be in the process. Some devices record the heart’s activity on an ongoing basis without you doing anything. Others rely on you pressing a button or doing something to start a recording.
- If you use your smartphone or smartwatch to track any heart measures and how this information should be used. These should be seen as add-on tools, and not a replacement for standard, medical testing. Care needs to be taken in interpreting the information you get. It’s also important not to become overly concerned or obsessed with checking, which can cause added anxiety for some.
- Any downsides if you decide not to monitor right now.
8 Tips to Get the Most From a Heart Monitor
Your care team should go over the instructions with you. Be sure to let them know if you are allergic to or sensitive to tape or other adhesives on skin. In general, it’s also a good idea to:
- Wear the monitor as much as you can. Most are intended to be worn all the time, even while you sleep.
- Make sure the leads (wires) or sensors are secure and in the right position.
- Avoid getting it wet. Some monitors are water-resistant, meaning that you can take a shower, but taking baths or swimming are not advised while wearing one.
- Not use oils or creams on the skin near where the sensors are placed. Oils or creams might cause the sensors to come loose. If the device is irritating your skin, let your care team know.
- Activate a recording as soon as you feel symptoms to mark the time. Many monitors have a button or some other way of telling the device to save information about your heart activity if and when you have symptoms.
- Keep a diary of symptoms, as well as what you were doing at the time to help give your care team a more complete picture of what you feel, when and if it relates to your heart.
- Make sure you have a strong Internet connection if the monitor you use sends data for ongoing review and reporting to your care team if anything is concerning.
- Ask if you need to avoid magnets, electric blankets or other situations that that could disrupt how well the monitor works.
Source: https://www.cardiosmart.org/topics/heart-rhythm-problems