What Are Holter Monitors and Zio Patches?

I am a respiratory therapist. I work at a small hospital and thus we are often asked to set up Holter monitors and Zio patches. These are often ordered on people complaining of symptoms that may be caused by your heart. So, what are Holter monitors? What do they show your doctor? Here’s what to know.

Why would you need a Holter monitor?

They are monitors that attach to your chest and work similarly to how EKGs work. I will provide a quick review here.

Your heart has a natural pacemaker. It begins each heartbeat by creating an electrical impulse. This impulse travels through your heart. This impulse causes your heart muscle to contract. As your heart contracts blood is pumped to your lungs and all the tissues of your body.

An EKG measures the flow of this electrical impulse through your heart. It places this impulse on a six-second graph. A doctor can then read the graph to determine how your heart is doing. Is your heart rhythm normal? Is it too fast or slow? Is your rhythm irregular? These can all be seen on an EKG.

An EKG is limited

However, an EKG is limited. It can only show what your heart is doing right now. Sometimes patients experience symptoms that warrant an EKG. For example, your heart starts racing or you feel chest tightness or dizziness. An EKG is done but it looks normal for you right now.

When this happens, a doctor may consider ordering an “ambulatory EKG.”1 This is what is possible when you wear a Holter monitor. It monitors your heart rhythm over a span of 24-48 hours

What is a Holter monitor?

It’s a small monitor about the size of an iPhone, maybe slightly larger. Modern ones contain computer chips that record your heart rhythm for a duration of 24-48 hours. Leads from the device are attached to stickers. These stickers are carefully attached to your chest.

It takes a little bit of time to set up. I will have you lie on your back. I then prep your skin to rub off any hair or oils. This is important to make sure the stickers don’t fall off before the test is done.

I may give you a pouch to slip the Holter monitor into. This can then be strapped over your shoulder. It can also be worn around your neck like a pendulum or necklace. They can also be hooked to your belt. When you’re sleeping they can be gently set alongside you on your bed or recliner.

The basic things you do

I will also give you a diary. In it, I ask you to record some of the basic things you do. If you mow your lawn or blow snow, it’s important to record these things. If you decide to go for a job this is important to record. What time you go to bed and get up in the night. These are important to record so the doctor who reads it knows what you were doing if an event occurs on the EKG.

If you experience any symptoms, you are to record these too. A doctor deems that you are healthy enough to go home with a Holter monitor. Your doctor or nurse will go over with you at what point, or what symptoms, require you to seek immediate medical attention. Other than that, symptoms should also be recorded in the journal. You may also press a button on the monitor when you experience symptoms. For instance, if you feel your heart palpating or chest tightness.

No showers

The only stipulation I’m told to tell patients is not to take showers. It also may be a good idea to avoid electric blankets. Other than that, it is safe to go about your normal daily activities. Once the 24 or 48 hours is up, the device is returned to where you got it from (doctor’s office, clinic, or hospital). A qualified doctor will read it and let your doctor know the results. It's a simple test.

Technology evolved

The first Holter monitor was devised in 1957. It was the size of a small briefcase.1 Modern Holter monitors are small and relatively convenient to carry. They allow doctors to monitor your EKG over a period of 24-48 hours. Ideally, it will confirm that your heart is functioning perfectly fine. This should give you reassurance your heart is okay. However, if you are experiencing events, these will show up. Your doctor can then lead you towards the best treatment for you.

Zio patch

A newer test is called a Zio Patch. These are devices that are gradually replacing Holter monitors. They attach to the upper portion of your left chest and monitor your EKG for one to two weeks. This test is nice in that it's very convenient for YOU. Yet, at the same time, they provide great information about your heart for your doctor.

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