Ambulatory (portable) ECG monitor

Many heart rhythm problems come and go, and they rarely happen during the few minutes of an ECG in clinic. An ambulatory ECG, also called a Holter monitor, records your heart continuously while you go about your normal life, so that any symptom you feel can be matched against your heart rhythm at that moment. It is used for:

• palpitations, a fluttering, pounding or racing heartbeat
• dizziness or blackouts
• suspected atrial fibrillation that comes and goes

Sticky pads are placed on your chest, and the wires from them are taped down and lead to a small recorder worn on a belt around your waist. You then go home and carry on with your usual routine, including the activities that normally bring on your symptoms, because that is what the recording needs to capture.

Keep a diary of any symptoms: the time, what you were doing and what you felt. You cannot have a bath or shower while wearing the recorder. Some pads are very sticky, so mention it if you have sensitive skin.

When the recording is finished, the recorder is returned so that the recording can be analysed and compared with your diary. Dr Vasudeva then goes through what it showed.

If your symptoms happen only every week or two, a few days of recording may miss them. A ZIO patch records for up to 14 days and is water resistant, so you can shower while wearing it. For symptoms that are rarer still, a small implantable loop recorder placed under the skin can monitor the heartbeat for up to three years.