LONG TERM MONITORING: DEVICES PLACED ON SKIN
Long-term monitoring; devices placed on the skin
Long-term cardiac electrical recordings provide information on your heartrate; the regularity of your heartbeat, abnormal moments of electrical silence, and much more.
This information can help diagnose certain health problems, including: syncope (unconsciousness) of unknown causes, suspicion of heartbeat disorders (for example, atrial fibrillation) that caused a stroke (paralysis), as well as some uncomfortable palpitations not detected by standard recording methods.
Above all, it is good to review some basics.
The electrical system of the heart and its recording
The heart is a great pump that ensures blood circulation throughout the body. To achieve this, each beat requires an electrical pulse that rushes through a conduction network. This normally results in a regular heartbeat whose frequency varies according to the specific needs in each given situation.
Cardiac electrical signals can be recorded by small sensors (electrodes) placed on the skin. They are then transcribed on a graphic document. This is the main purpose of the electrocardiogram (ECG) which has been used countless number of times for many, many years. This simple exam in cardiology is however limited to a recording of ten seconds only. The diagnosis of cardiac arrhythmias most often requires more prolonged monitoring obtained by various methods which will be described later.
The recording of the heart's electricity can be done in different ways either over a short period of time or over a longer period of time. For example, the electrocardiogram records it for a few seconds, while the Holter monitor records for a period of 24 or 48 hours.
Two types of long-term recordings
There are various types of monitors that record cardiac signals over longer periods of time. These systems collect cardiac signals either on the skin (external) or through a miniature monitor that is implanted under the skin (internal).
Long-term cutaneous recording (external)
Two forms of recordings on the skin are possible:
• the first uses electrodes stuck to the skin that are connected by wires to a portable device;
• thesecond uses a device placed on the skin during palpitations or other symptoms for which a rhythm disorder is sought.
Cutaneous devices with “King of heart” type electrodes
Cutaneous devices exist under several names.
You need an appointment
To receive these devices, you must have an appointment.
A request is then sent to the health’s professional’s office. You will be informed by phone or by mail of the date and time of your appointment.
The day of the appointment
On the day of the appointment, simply show up as scheduled with no particular preparation. There is no need to be fasting.
However, it is recommended that you bring an up-to-date list of your medications.
Installation on your chest
During this appointment, small electrical sensors are installed on your chest.
These, well attached to the skin, record the electricity emitted by your heart.
For a better electrical contact
If there is hair on the chest, the area where the electrodes will be installed will be shaved. Do not applying any moisturizer or skin cream to your chest the day of your appointment as the electrodes may not stay in place very well.
A recording box worn at the waist
The sensors are linked to a box by small electrical wires. The device easily supported at the waist or with a strap on the shoulder.
A button in case of perceived palpitations
There is an instant save button on the case. Just press if you feel palpitations. After being activated, it will actually record the information from a few seconds before and after the pressing of the knob.
We know when you activated the recording
When we read the recording, we know the time you activated the recording and see the electrical activity of your heart at that moment.
Activate the recording only a few times, since we need to save space so that recordings are possible for all the prescribed time.
You can keep a small journal of your palpitations and hand it in when you return the device.
This can corroborate the information recorded.
Additional electrodes will be given to you. This allows you to remove the older ones for personal hygiene and to install new ones afterwards. The device is afraid of water!
It may still happen that some patients do not have to be connected to the device when there are no symptoms. However, it is recommended to stay connected as long as possible in order to record as much information as possible before returning the device.
Returning the device
During the installation of the device, you are told the exact moment you have to return it.
Out of respect for other patients, the device must be returned on the scheduled date because it may be attributed to someone else.
On the agreed date, the results are communicated to the doctor who requested the examination.
You can request a copy for another doctor
A copy of the results may be sent to another doctor, if you request it.
Simply give the name and contact information of this doctor to the staff when installing or removing the skin monitor.
Device as needed, without electrodes attached to the skin: Cardiomemo
No installation required
At the time of this appointment, you are given a small device to carry on you. The electrical sensors on the side of the device record the electrical activity of the heart when placed directly on the skin of the chest.
An easy-to-hide case
The device is hidden very well in a trouser pocket or purse. It is sufficient to apply it on the thorax when the symptoms are manifested.
A device just in case
This may suggest that it is easier to use. Certainly, but you should know that it only records when it is applied to the skin. If there are arrhythmias that do not cause symptoms, they will not be recorded.
The recording may be of lower quality than other devices using sensors glued to the skin.
You can keep a small journal of your palpitations that you will hand over when returning the device. This information may corroborate the recordings.
Returning the device
When you receive the device, the staff tells you when you need to return it.
Out of respect for other patients, the device must be returned on the scheduled date. This unit may already be lent to someone else.
When the device is returned, the results are sent to the doctor who requested the examination.
You can request a copy for another doctor
A copy of the results may be sent to another doctor, if you request it. Simply give the name and contact details of this doctor to the staff when installing or removing the Cardiomemo.
Different devices compatible with a smart phone
Some devices that record the heart's electricity are compatible with a smartphone. They work in much the same way as the previous device. Recording is done by placing the fingers on a metal plate. The information is transmitted to the smartphone and is therefore available when you meet with a health professional.
The Alivecor of Kardia and the Apple Watchman also records this kind of information.