Ambulatory Electro-Cardiography Health Article

Aftercare

The electrodes are removed after the monitoring period is completed and the patient may return to normal activities. Results are generally available a few days after the test is complete.

Complications

The only limitations to these monitoring procedures is the need to have recorded the heartbeat during an abnormal event. There are no physical complications that result from the monitoring.

Results

A standard ambulatory EKG will record all the beats of the heart for the period that the device is connected to the patient, while an event recorder will have signals recorded only for a short period after the event button was depressed. Computers are often used as a first stage review the lengthy tapes produced by standard ambulatory EKG testing. The program will highlight abnormal rhythms or abnormal signal shape for closer inspection by the doctor. Some standard monitors are equipped with an event button that highlights electrical output during symptoms. This helps the doctor correlate symptoms with electrical signals, similar to what occurs with a event recorder.

"Silent" ischemia is detected by a change in the shape of the heartbeat signal. In electrocardiography, the five different waves seen in a normal heartbeat are labeled PQRST. Reduced oxygen to the heart often changes the shape of the ST portion of the electrical signal.

If the purpose of the test is screening for arrhythmias, the recording will be reviewed for any atypical electrical patterns. Among the abnormal patterns that can be seen are transient brachycardia (sporadic abnormally slow heartbeats), atrial fibrillation (rapid, unproductive contraction of the atria), atrial tachycardia (abnormally fast beating of the atria), and paryoxsmal supraventricular tachycardia (PSVT), a sporadic fast heartbeat that starts above the ventricles.

If the test is performed to evaluate a treatment, the doctor or technician will scan the record for a return to normal rate and graphic shape of heartbeats.

Health care team roles

Specially trained assistants known as electrocardiograph technicians often prepare patients for ambulatory EKG testing in larger hospital and cardiology group

KEY TERMS

Arrhythmia—An abnormal rhythm of the heart, if transient (periodic) it is often diagnosed using ambulatory EKG.

Cardiomyopathy—A disease of the muscle of the heart.

Ischemia—A lack of oxygen to a tissue, cardiac ischemia is often due to clogging of the coronary arteries.

Palpitation—An unpleasant awareness of the heart beating, can also encompass skipped beats or rapid beats.

Syncope—A loss of consciousness, fainting, a condition that can be caused by heart disease.

practice settings. In small settings, nurses and medical assistants set up the test. A doctor, often aided by a computer, usually does the final interpretation of the tracing.

Training

Many persons learn how to perform ambulatory EKG monitoring through on the job training. However, training programs for EKG work in general, that includes ambulatory techniques, are available through out-sourcing companies or in vocational and community colleges. The usual length of these college-based programs is 465 hours (four months). Program content includes classroom instruction in anatomy and physiology with an emphasis on the cardiac and vascular system, medical terminology, cardiovascular medications, patient care techniques, interpretation of cardiac rhythm, medical ethics, and a clinical practicum.

BOOKS

Topol, Eric J., ed. Cleveland Clinic Heart Book New York: Hyperion, 2000.

PERIODICALS

Bubien, Rosemary S. "A New Beat on an Old Rhythm." American Journal of Nursing 100 (January 2000).

Sadovsky, Richard. "Ambulatory Arrhythmia Monitoring Devices." American Family Physician (December 1999).

ORGANIZATIONS

American Heart Association. 7272 Greenville Avenue, Dallas, Texas 75231. (800) AHA-USA1. <http://www.americanheart.org>.

Michelle L. Johnson, M.S., J.D.