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Non-diagnostic Holter, Symptomatic Patient…Now What?

When a patient expresses symptoms or exhibits signs of a cardiac irregularity, many cardiologists look to the Holter monitor as their first line of defense. While Holter monitors can be effective, it’s not uncommon for them to be returned as non-diagnostic. In fact, many physicians report non-diagnostic rates as high as 85%. Most often, this is because symptoms may not reappear in the 24 to 48 hours during which the Holter is monitoring the patient’s heart rhythm. Non-diagnostic Holters are also known as a benign Holter or a negative Holter.

Non-diagnostic results… now what?

Cardiac irregularities should not be dismissed even when a cardiologist receives a non-diagnostic Holter. The suspicion of an arrhythmia warrants additional steps. Many cardiologists will prescribe the use of a Holter monitor for a longer period. If the patient’s condition is infrequent, or if the patient is asymptomatic, then a passive recording system could be a more appropriate choice.

Some recording systems can be activated by the patient when he or she becomes symptomatic. Other systems utilize a Mobile Cardiac Telemetry (MCT) device that continually transmits EKG data back to a staffed monitoring center. If an abnormality is detected, the system will create an event and generate a report which documents the irregularity with full onset and offset as well as comprehensive ectopy reporting.

Many physicians who do not own a Mobile Cardiac Telemetry system choose to utilize a service-based cardiac monitoring provider, such as Telerhythmics. A cardiac monitoring service company can allow you to offer the technology without having to purchase the equipment. Plus, if you’ve never used a Mobile Cardiac Telemetry system, they will teach you how it works and train your staff on how to provide the service.

As always, regardless of which technology or service you choose, it’s most important to continue monitoring the patient until a diagnosis can be made.

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