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HOLTER MONITOR
CARDIOTEL uses the latest Rozinn model RZ153+ digital holter. It is an AAMI type 1 device, which is part of a conventional AECG monitoring system where the ECG is recorded on the CompactFlash memory card in the RZ153+.
Holter Monitor Use :
The Holter monitor is the first stage in transtelephonic monitoring of a patient with suspected heart disease. The Holter monitor is a portable electrocardiogram (EKG) that monitors the electrical activity of an ambulatory (freely moving) patient’s heart for one to five days, 24 hours per day. There are two types of Holter monitors: Analogue and Digital. The most widely used is the digital because it allows the physician to transmit the data saved on the monitor’s memory card via the internet during off hours. The Holter monitor is most often used when the physician suspects an abnormal heart rhythm or that the patient is experiencing times when the heart is not getting enough oxygen-rich blood.
CARDIOTEL provides Holter monitors to physicians who then attach the monitor to a patient in order to record cardiac activity over a longer time period during normal activity.
The Holter Monitor is a simple device to apply to a patient. Five to seven ECG electrodes are attached to the skin to record the electrical activity of the heart.
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The Holter Monitor is connected to the electrodes by thin wires. With the use of a belt or shoulder harness, the Holter Monitor can be worn comfortably by the patient. |
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Patients are encouraged to perform their daily activities while wearing the device with the exception of bathing, showering, swimming or any activity that would get the monitor wet. The patient is provided with a diary to record normal activities as well as any symptoms and the times that these events occurred. The diary allows the proper correlation between the findings on the Holter tape and potential heart rhythm disturbances.
Upon completion of the recording period, the analogue Holter monitor is returned CARDIOTEL and the patient’s cardiac activity is analyzed by a trained and certified cardiac technician. With the digital Holter, the information on the memory card is transmitted via the internet from the physician’s office to a receiving station within CARDIOTEL. The data is then uploaded and analyzed by a trained and certified cardiac technician. A report is placed into a secure and password protected folder on CardioTel’s server where the physician can retrieve the report from anywhere in the world. If the physician chooses, the report can also be faxed or sent by courier to their office. The analysis results in a Holter monitor report that includes:
- Hourly summaries of the minimum, maximum and average heart beats for the 24-hour period.
- Abnormal slowing of the heart beat (called Bradycardia) and abnormal fast heartbeats, (called Tachycardia).
- Analysis of a particular portion of the EKG signal which may indicate a problem with poor blood flow to the heart muscle, (called ischemia).
- Measurement of any pauses in the heartbeat.
- Evaluation of pacemaker functioning, (if one is present).
- Evaluation of the effectiveness of certain cardiac medications.
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Cardiac Event Monitors
Cardiac Event Monitor Use :
The second phase of transtelephonic monitoring is the use of a Cardiac Event Monitor. This device is typically prescribed to approximately 70% of the patients who wear a Holter monitor. A Cardiac Event Monitor is a small, lightweight unit designed to document the symptomatic patient's pre and post Electro-Cardiographic activity, and transmit the signal to any analog receiving station. The device typically includes a convenient belt clip holster, and is easy to wear, measuring smaller than a standard pager. Monitoring devices offer a variety of memory modes to accommodate the duration of any symptom type, and transmits the ECG with superior signal quality. There are two basic event monitors: the looping, which records pre and post event symptoms and the non-looping which records post event symptoms. A third monitor, which is a looping monitor, is the auto-trigger. This monitor, because it does not need to be activated by the patient, is typically prescribed to the elderly and children. All other monitors must be activated by the patient in order to record the patient’s symptoms.
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Pacemaker Monitor Pacemaker Monitor Use :
The third device to be used is the Pacemaker. If the physician determines, from the use of the Event monitor, that the patient’s arrhythmia can be controlled with the use of a pacemaker one may be implanted. The patient would then be referred to CARDIOTEL for monthly scheduled monitoring the pacemaker. Transtelephonic monitoring is one of the most useful techniques available for the long-term observation of patients with implanted cardiac pacemakers. Routine telephone monitoring provides the patient with a safe, effective, and convenient means of having his or her pacemaker monitored. In addition, a transtelephonic surveillance system can help detect pacemaker system failures caused by:
- Loss of Capture
- Threshold Change
- Under Sensing
- Lead Dislodgment
- Over Sensing
- Lead Failure
- Conductor Failure
- Insulation Failure
- Electrical Disruptions
- Circuit Failure
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The pacemaker transmitter is a battery powered portable medical device that converts the patient's electrocardiographic activity into a frequency modulation signal for the purpose of transmitting the information over standard telephone lines. This product is for use in conjunction with a pacemaker follow-up program that is performed by a professional service or the patient's physician office. This is a standard diagnostic procedure as defined by the American Medical Association's Physicians' Current ProceduralTerminology (CPT) codes 93733 or 93736 for electronic analysis of single- or dual-chamber internal pacemaker system; telephonic analysis.2 This procedure usually begins with the ECG technician or medical assistant calling the patient for a periodic follow-up. The patient will be instructed to provide the ECG signal with one of several standard electrode configurations. |
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Ambulatory Blood Pressure Monitor
Ambulatory Blood Pressure Monitor Use :
Ambulatory blood pressure monitoring is the process of fitting a patient with a portable monitor that takes periodic blood pressure reading over the course of a 24 hour period, or longer. Afterwards, the collected data can be viewed with a software that provides a much more accurate and comprehensive representation of the patient’s blood pressure profile.
Twenty-four-hour ambulatory blood pressure (BP) recordings sometimes show that office BP measurements don't reflect outside readings accurately. Ambulatory BP appears to have independent prognostic value, beyond that of office measurements, in patients who receive drug therapy for hypertension.
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CardioTel Diagnostics’ ambulatory blood pressure (ABP) system is designed to provide a reliable and complete ABP monitoring that is easier to set-up, use and maintain. The Oscar 2 interfaces with AccuWin Pro™ V3 software, our most powerful tool for ABP programming, data analysis and report generation. |
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