Healthy Aging

“Hi, This is the Cardiology Department…”

‘’Hello, this is the cardiology department. We’d like to fit you with a cardiac monitor. When can you come in?”

This call is a surprise for some who haven’t noticed any heart-related symptoms. For others, it’s expected, as their doctor has been trying to get to the bottom of symptoms or monitor how well their heart medications are working.

Uh oh

For me, it was a surprise. I don’t even have a cardiologist!  I had fainted in urgent care, after I sliced off a big chunk of pinky finger along with the fresh cucumbers. The pain was intense, the bleeding wouldn’t stop, and once at urgent care, I decided to just pass out. The cardiology department at my HMO wanted to get to the bottom of it.

Why a heart monitor?

As technology has advanced, the ability of cardiac monitors, as well as usage, has grown. The devices collect the same information as an electrocardiogram, or ECG (also called EKG), but provide more thorough information.

…an EKG is often not enough information to understand the status of your heart health adequately.

“An EKG is a 10-second snapshot,” says Suneet Mittal, MD, chair of cardiology and electrophysiology for Valley Health System, Ridgewood, NJ, consultant for  iRhythm, a digital healthcare company, and a member of the Heart Rhythm Society.  And an EKG is often not enough information to understand the status of your heart health adequately.

“Over time, a number of external monitors have been developed,” Mittal says. One of the most common is a Holter monitor,  a kind of portable EKG. Small, plastic patches, called electrodes, are put on the skin of the chest and abdomen; they’re connected to an EKG machine by wires to measure the electrical activity of the heart. It can be worn for 24 to 72 hours, and captures every heartbeat, Mittal says, so the cardiologist can evaluate your heart beat and rhythms and detect heart-related issues.

More time, more info

But even 72 hours may not be enough to get a full picture, he says, so longer-term monitors have been developed. Among the most commonly used, Mittal adds, are the patch-based monitors.

Adhesive patches are attached to the chest and left on for 1, 2 or 4 weeks to obtain data. (My kind; yes, you can shower without removing them.) Another category: monitors that place a loop recorder under the skin, which can stay in place up to 5 years. There’s also been increased popularity of consumer grade devices, he said, such as the smart watches. “These are all forms of ambulatory, external EKG monitoring. Which one is best for the patient depends on what you are looking for” and other factors, he says. For some models, you carry a monitor with you; some require you to press a button when you notice a symptom.

What about Heart Monitoring Apps?

Although heart monitoring apps are popular there’s one caveat on the smart watches, Mittal notes.  Their  notifications about a fib are not always accurate. “There is no question that the notification can be inaccurate—for example, we know that the performance of many of these algorithms is less robust when users are in motion as compared to at rest.” Much research is underway to decrease the false notices. One new option under study is a medical-grade wrist-worn device providing continuous monitoring and more accurate results to detect a fib.

Why are Heart Monitors prescribed?

Monitors may be prescribed if:

You have symptoms, such as a fluttering sensation in the chest or palpitations, he says. Your doctor wants to determine if an abnormal heart rhythm—such as atrial fibrillation—is present.

You have a fainting episode.  Your doctor may decide your heart needs investigation.

You had a stroke with an unclear cause.  You’d likely get a monitor to search for the abnormal rhythm known as atrial fibrillation, which boosts risk of stroke. Those diagnosed with afib may get a monitor to evaluate how well the therapies for the condition are working.

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Heart Monitor basics

For elders only? No. It’s not always an “age” thing, Mittal says. Monitoring occurs at all ages.

Covered?  Coverage varies, so it’s good to ask. Some monitor companies offer financial assistance.

What to ask:  “Most important is to understand from your physicians what they are looking for,” Mittal says. Find out how long you are expected to wear it. If you have sensitive skin and are given the patches, ask if hypoallergenic options are available. (My skin turned red and wasn’t happy, but it’s fine now.) Be sure you know the logistics—do you pack up the device and ship it back, or take it to your doctor’s office?

Is there customer service? If you’re having issues or still have questions, the monitor companies generally offer 24/7 telephone support.

Ask what’s next. Get an idea of when to expect results, and know you may need help interpreting them.  “Sometimes having a negative test is just another data point that reassures the physician and patient there is nothing much more to worry about,” Mittal says.

Amen to that. My test came back AOK.

 

YOUR TURN

What was your experience with heart monitors?  How did it help? Let us know in the comments!

Kathleen Doheny is a Los Angeles-based independent journalist, specializing in health, behavior, fitness and lifestyle stories. Besides writing for Senior Planet, she reports for WebMD, Medscape, MedCentral and other sites.  She is a mom, mother-in-law and proud and happy Mimi who likes to hike, jog and shop.
Doheny photo: Shaun Newton

This article offered by Senior Planet and Older Adults Technology Services is for informational purposes only and is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition. If you think you may have a medical emergency call 911 immediately.
 

COMMENTS

One response to ““Hi, This is the Cardiology Department…”

  1. My Apple Watch notified me that it had detected a afib. My cardiologist corroborated this by reviewing the ECG taken after the event. He then had me wear a Holter monitor for 30 days, which revealed 18 a fib events during that time. I was put on a blood thinner immediately & eventually had a cardiac ablation, which has been succesful. I think the Apple Watch system is likely to be correct & Apple has a Health Care department which investigate unusual reports on the Watch

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