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Why It’s Done

What is Remote Monitoring?

Often, pacemakers and ICDs are equipped with a special transmitter so that remote monitoring may be done. The pacemakers and ICDs automatically sends medical and technical information from your heart from the comfort of your home to your cardiologists who are treating you. This allows your doctor to monitor your condition based on accurate up-to-date clinical information at any time.

In order to send the signals from your ICD or pacemaker you will need a special transmitting device. This may look like a large mobile phone or may be a box which you will need to plug into your telephone line. The type of transmitter you receive will depend on which company made your implant. Sending transmission from home remotely to the heart doctors office allows the cardiologist to check battery status, detect arrhythmias, provide lead data, confirm delivered therapy, and some can also check on fluid retention and therefore provide early warning signs of heart failure.

Types of Monitoring

Event Monitoring

An event monitor is a small, portable device that patients wear to record their heart activity.

Unlike a holter monitor, an event monitor does not record a patient’s heart activity the entire time they’re wearing it. Rather, it documents activity during certain times or events.

A technician at the receiving center will tell you exactly where to place the electrodes and how often to change them. You can wear the electrodes in the bath or shower.

Cardiac event recorders that you hold or wear on your wrist don’t require electrodes on your chest. Instead, you place the device against your chest and press a recording button, or press the recording button on the wrist monitor when you have symptoms.

FAQs

  • A specially trained technician will attach the holter monitor and instruct you how to record your symptoms while wearing it
  • The technician first attaches the electrodes to your chest. If you have a hairy chest, he or she may shave some hair off to attach the electrodes firmly
  • Once the electrodes are in place, the technician helps you put the holter monitor on and explains how to take care of it
  • You can carry the monitor in a pocket or pouch, slung across your shoulders and neck like a purse or attach it to your waist

A looping memory monitor and symptom event monitor.

A looping memory monitor is a small device about the size of a pager that can be programmed to record your ECG for a period of time, such as 5 minutes. You must push a button to activate it, and it stores your ECG for the period before and during your symptoms. If you faint and push the button after you recover, it will record your ECG during the time you felt faint and right after you pushed it.

A symptom event monitor can be either a hand-held device or worn on your wrist. When you feel a symptom or irregular heartbeat, you place the monitor on your chest and activate a recording button. The back of this device has small metal discs that function as the electrodes. If the monitor is worn on a wrist, you press the button to record. Unlike the looping memory monitor, these won’t store your ECG before you activate it.

Both devices can send your ECG by telephone to a transmission or receiving center in the hospital, doctor’s office or clinic. If the tracing indicates an emergency, you will be asked to go to the emergency room.

Cardiac loop memory monitors have small disks that attach to your chest. From there, wires are attached from the electrodes to the device.

To get a good ECG recording:

  • Your skin should be free of oils and creams
  • You should clean your skin with alcohol and rub until the skin is slightly pink

You may need to wear an event recorder for several days or up to a month. With several recordings, we will be able to decide if your irregular heartbeats require more tests or treatment.

Risks

What Are the Possible Risks of Remote Monitoring?

Remote monitoring carries no risks and causes no pain. Some patients may report minor skin irritation in the places where the electrodes attach to the chest.

Please let us know if you’re allergic to any sort of tape or adhesives.

After the Procedure

What to expect after wearing a holter monitor

After the test period, you will return your monitor with the record of your heart activity and any notes you have in your diary. We will evaluate the results and generate a report.

Generally, the results will be available in one to two weeks.

Activity guidelines

Do your usual activities while you wear the monitor with these exceptions:

  • Do not bathe, shower, or swim while wearing the monitor
  • Do not have X-rays while wearing the monitor
  • Stay away from high-voltage areas, metal detectors, or large magnets

The technician will show you how to keep a diary of your activities and symptoms during the test, and it’s important that you record accurate information.

If you feel symptoms such as chest pain, shortness of breath, uneven heartbeats, or dizziness, note in your diary the time of day they began and what you were doing. Your diary will be compared to the changes in your ECG recorded by the holter monitor.