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When symptoms such as dizziness, fainting, low blood pressure, prolonged fatigue, or palpitations continue to occur without a definitive diagnosis obtained with a resting EKG, your child's physician may request an EKG tracing to be run over a long period of time. Certain arrhythmias (a fast, slow, or irregular heartbeat) that can cause the symptoms noted above may occur only sporadically, or may occur only under certain conditions, such as stress. Arrhythmias of this type are difficult to obtain on an EKG tracing that only runs for a few minutes.
A prolonged type of EKG tracing, called a Holter monitor, provides the physician a better opportunity to capture any abnormal heartbeats or rhythms that may be causing your child's symptoms.
The Holter monitor test is used to record your child's EKG tracing continuously for a period of 24 hours. You will receive instructions on how long your child will wear the recorder (usually 24 hours, but sometimes longer), how to keep a diary of your child's activities and symptoms during the test, and personal care/activity instructions.
Event monitoring is very similar to Holter monitoring, and often is performed for the same reasons. Event monitors can be used when symptoms happen several times a week or month but not every day. There are two kinds of event monitors: loop and memo. With a loop event monitor, your child wears EKG electrode patches on his/her chest, and the electrodes are connected by wire leads to a recording device. Unlike the Holter monitor, which records continuously throughout the testing period of 24 to 48 hours, the event monitor does not save the rhythm until your child feels symptoms and you or your child trigger the monitor to record the EKG tracing at that time. It then captures the rhythm just before the button is pressed, and for a short period following the activation. The auto-trigger event monitor automatically records rhythm events and can be manually activated if your child experiences symptoms.
With the memo event monitor, the patient or parent puts a card against the skin when there are symptoms. The card then records whatever the current rhythm is. When your child feels one or more symptoms, such as chest pain, dizziness or palpitations, one of you will push a button on the event monitor recorder. Some monitors have a feature called "memory loop recording," in which the monitor can include a recording of a short period of time prior to and after the moment you triggered the recording. This feature can help your child's physician determine more details about the possible change in your child's EKG at the time the symptoms started, and what was happening with your child's EKG just before you or your child triggered the recorder. Other monitors, called "post-event recorders," simply start recording the EKG from the moment you trigger them.
After symptoms are experienced and recorded, you will send the recording to your child's physician or to a central monitoring center. You also will keep a diary of your child's symptoms and corresponding activities, just as with the Holter monitoring procedure.
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Holter & Event Monitors
