Ambulatory monitoring is the assessment method used to evaluate the patient having cardiac arrhythmia or conduction abnormality symptoms. It usually records the heart rate, heart rhythm, or blood pressure while performing usual activities. Ambulatory means an individual can walk during tests.
Electrocardiographic monitoring (ECG) of an ambulatory patient helps doctors diagnose intermittent and unpredictable arrhythmias. A person with such an arrhythmia may experience sudden symptoms that, however, typically disappear by the time they see a physician. Due to this reason, an electrocardiogram cannot diagnose many arrhythmic conditions that produce symptoms.
In ambulatory ECG monitoring, your heart rhythm can be recorded for much more extended periods of time-days, weeks, or even years-greatly increasing the likelihood of detecting and recording such brief, intermittent arrhythmias. Several ambulatory ECG monitoring systems are available today to accommodate the different clinical settings. A practitioner can better help you decide whether you might benefit from ambulatory monitoring or not.
Difference between Standard and Ambulatory
In a standard ECG, the electrical activity of your heart is recorded for approximately 10 seconds. Using an echocardiogram, your health care provider can determine whether your heart has suffered from a heart attack, ischemia (insufficient blood flow), whether your walls are hypertrophic (too thick), or whether you have other kinds of structural heart diseases.
The standard ECG may not be sufficient in diagnosing cardiac arrhythmias. However, it rarely occurs and may last only for a short period when heart rhythm disturbances occur. An ECG taken at different times, or even a standard ECG, is likely to miss these rapidly recurring arrhythmias.
As with cardiac arrhythmias, the symptoms of these conditions may only last a few seconds. In a patient experiencing such symptoms and receiving medical treatment, both the symptoms and the arrhythmias are likely to go away by the time they have been treated, leaving everyone wondering what just happened.
You can monitor your heart rhythm for an extended period using ambulatory ECG monitoring systems. A brief intermittent arrhythmia is much more likely to be captured and recorded with this method. You may use this technology to monitor your heart rhythm while exercising, going through psychological stress, or sleeping.
Transient arrhythmias during the times mentioned earlier can often appear much more frequently than when you are lying quietly on an exam table. Ambulatory heart monitoring is a useful method for identifying apparent cardiac arrhythmias and ruling them out using various available tools.
Why do you need an ambulatory monitoring test?
Ambulatory ECG monitoring is used when people experience transient heart rhythm disturbance symptoms. Most often, these symptoms are accompanied by one or more of the following symptoms:
- Syncope
- Near syncope
- Feeling light-headed suddenly
- Recurring palpitations
In the event of syncope, near syncope, or lightheadedness caused by an arrhythmia, your healthcare provider might be concerned that you have a dangerous arrhythmia. Although vibrations are much less alarming to practitioners, they still worry the individual who experiences them. It is essential to diagnose any of these symptoms when they appear correctly. A diagnosis can usually be made more quickly through ambulatory monitoring.
It is also helpful to monitor ambulatory ECGs to evaluate how effectively a cardiac arrhythmia treatment is working or assess how likely a person is recovering from various types of underlying heart disease (or other types). An ambulatory ECG monitor, for instance, is routinely performed for the following:
- Assessment of the effectiveness of ablation procedures for the treatment of atrial fibrillation or other arrhythmias.
- Patients with some conditions known to cause arrhythmias, including Long QT syndrome, Brugada syndrome, arrhythmogenic right ventricular cardiomyopathy, or hypertrophic cardiomyopathy, should undergo screening for this condition.
- To monitor anyone who has suffered a stroke with an unknown cause for asymptomatic episodes of atrial fibrillation.
- To determine whether asymptomatic heart ischemia (intermittent starvation of oxygen to the heart) occurs in patients with known coronary artery disease.
How to prepare for the test?
It would be best if you preferably took a bath before the test. As a result, removing the electrodes and bathing again may take a day or two, depending on the test. Your chest skin should be clean regardless of whether you choose to bathe.
Therefore, it is not recommended to apply any oils, lotions, creams, or other skin care products to the chest area. As a result, the electrodes may have difficulty sticking to your skin and detecting your heartbeat. In addition, it would be ideal that you wear an easy-to-take-off, easy-to-put-on shirt so that the electrodes can be applied easily.
Before Test
A health professional explains how to operate the device. A technician or other health professional also demonstrated it. Depending on the device, you may also be instructed on putting on and taking off the electrodes yourself after swimming, bathing, etc.
The monitor manufacturer will also tell you specific situations or devices you should avoid if you want the monitor to function properly. These usually include certain types of electronics and magnet-containing devices.
A list of devices to prevent may be provided to you, or you may request one. The skin around the electrodes on the monitors is cleaned with alcohol before insertion. In addition, they will shave or remove any hair, ensuring that the electrode stays attached and that a clear signal can be obtained.
During Test
A monitor test in an ambulatory setting is extremely safe and painless. The monitor needs to be worn and used according to the instruction of healthcare providers who are required to provide all other information you need for the monitoring period, such as technicians and nurses.
After Test
The electrodes (if the device uses them) will be removed after the test, and the device can be returned. The electrodes used with external monitors may irritate your skin lingeringly. However, this usually resolves itself after a short time. Depending on the cause of the irritation, your health care provider may be able to provide you with specific treatment and related recommendations.
What results will you get?
You will return the monitor after you have downloaded the data, and you will have a medical professional review. The physician may be able to diagnose the symptoms and specific disease of the patient once they have reviewed the data.
If your doctor’s office operates according to its policies, you may receive a phone call afterward. Providers will discuss the test results and the upcoming required procedure during the visit. There may be a need to schedule a follow-up appointment or refer you to another specialist.
References:
- https://www.verywellhealth.com/ambulatory-ecg-monitoring-4171275 retrieved on 10th December 2021.
- https://www.uofmhealth.org/health-library/aa10253 retrieved on 10th December 2021.
- https://www.uptodate.com/contents/ambulatory-ecg-monitoring retrieved on 10th December 2021.
- https://medical-dictionary.thefreedictionary.com/ambulatory+monitoring retrieved on 10th December 2021.
