Ambulatory Monitoring Flashcards
What indications are there for TTM (loop or event) (6)?
- syncope/fainting spells
- dizziness
- palpitations
- chest pain
- medication check
- pacemaker/ICD check
Which of the two TTM types are continuous vs. non-continuous?
Loop is continuous, event is non-continuous
Which TTM type is wireless?
Event, the electrodes are discs at the back of the machine. You hold the machine to your chest during an episode and press REC.
How does a loop recorder work?
A loop recorder continuously captures and stores your ECG.
What does the VE bin do in the CardioScan program?
Allows you to edit the VEs
Before giving a patient a recorder, what should the tech do?
- If giving a loop recorder, attach the leads to the electrodes.
- Choose the program on the recorder.
- Set up the room to do a 12-lead ECG (e.g. place paper on bed)
What is program 1 on the CardioCall?
Program 1 stores 1 min pre-event, 30s of an event, and 1 min post-event
Which CardioCall programs capture 30s of an event
Programs 1 and 3, the rest of the programs store 1 min of an event.
What is program 2 on the CardioCall?
Program 2 stores 45s pre-event, 1 min of an event, and 15s post-event (shortest post-event time).
What is program 3 on the CardioCall?
Program 3 stores 30s pre-event, 2 min of an event, and 30s post-event.
What is program 4 on the CardioCall?
Program 4 stores 4min30s pre-event, 1 min of an event, and 30s post-event.
What is program 5 on the CardioCall?
Program 5 stores 9min pre-event (longest pre-event time), 1 min of an event, and 1 min post-event.
What is program 6 on the CardioCall?
Program 6 has no pre-event recording, 1 min of an event recording, and 1 min of post-event recording
Which CardioCall programs have 2 channels?
Channels 3 and 4 have two channels.
If you want to set CardioCall to allow for as many recordings to be made as the storage capacity can handle, what is the protocol?
You push the yellow button 3 times.
Should you leave the programming key of a CardioCall device in after setting it up as needed?
No, this will waste the battery.
What 2 sounds will you hear when the memory of the CardioCall device is full?
When you try to start a recording, you’ll hear one beep. After making the recording, you’ll hear a four-tone ringing sound.
What will you hear that signifies a low battery for CardioCall?
You’ll hear a beep every 16s.
What will happen if you make a new recording even with a full memory?
The new recording will overwrite the oldest old recording. THe oldest old recording will be automatically deleted.
How do you check the memory and battery of CardioCall?
Push the green and yellow buttons together until you hear a beep, then release. However long the green and yellow buttons stay lit up represent how much storage space is left and how much storage was already used, respectively.
What does a series of tones falling in pitch mean?
The battery is almost dead.
What does a series of tones rising in pitch mean?
The battery has enough life in it.
What is an implantable loop recorder
An ILR is a 1-lead surgically placed ECG monitoring device in the left parasternal area, and will store ECGs when the HR comes outside of a certain range, or when the patient activates it. It’s best for infrequent symptomatic episodes that a regular ECG is unlikely to catch over years.
What can ILRs be used for (4)?
- Help diagnose people with cardiac symptoms (e.g. palpitations, syncope, fatigue).
- See how much aFib is in a given recording (aFib burden).
- Monitor post-MI patients
- For people with certain genetic disorders.
Between post-MI patients, suspect valvular disease, CHF, and HCM which condition is not an indication for Holter monitoring?
Suspect valvular disease is not an indication for Holter.
Is atrial fibrillation an indication for HRV analysis?
No.
What is Sotacor (sotalol) useful for (5 arrhythmia types)?
supraventricular tachycardia, atrial fibrillation, atrial flutter, deadly ventricular arrhythmias, sustained ventricular tachycardia
What are 5 contraindications for Holter monitoring (not pathological conditions)?
- Defibrillation
- Heating pads/heated blankets
- Water
- High-voltage areas
- Metal Detectors
Who invented the first ambulatory ECG monitoring machine, and in what year?
Norman J. Holter invented telemetric cardiac monitoring in 1949.
What was invented in 1962?
The first commercial AECG device, which was easier to use and much smaller.
What arrhythmia type is likely to occur in post-MI and/or CHF patients?
Complex ventricular ectopy and frequent PVCs are associated with higher mortality rate among survivors of MIs and/or people with CHF.
Between atrial fibrillation, DCM, idiopathic HCM, CHF, and post-MI with reduced EF, which three conditions are indicated for HRV monitoring?
Idiopathic HCM, CHF, and post-MI with reduced EF are all indications for AECG + HRV monitoring.
What class do patients with 1. unexplained syncope/near syncope, 2. unexplained episodic dizziness, or 3. unexplained recurrent palpitations fall under, with regards to indications for AECG?
Class I (general consensus is in agreement that AECG monitoring is useful for these types of patients)
What class do patients with
1. syncope/near syncope of known origin, 2. episodic dizziness of known origin,
3. recurrent palpitations of known origin, or
4. cerebrovascular accidents with no reason to suspect arrhythmia
fall under, with regards to indications for AECG?
Class III (general consensus is in agreement that AECG monitoring is useless or dangerous for these types of patients)
What class do patients with
1. unexplained episodic SOB, CP, fatigue 2. neurological problems with suspected atrial fibrillation or atrial flutter
3. syncope/near syncope, episodic dizziness, palpitations of an identified non-cardiac origin, that still have symptoms despite having gotten treatment for it
fall under, with regards to indications for AECG?
Class IIb (consensus is divided as to whether AECG is good for these types of patients)
