Now is not the time to halt Holters

Ambulatory ECG or Holter monitoring is the primary diagnostic test for cardiac arrhythmia. Approximately 500,000-600,000 Holter tests are performed by the NHS annually in the UK alone.

Holter monitoring is vital in the detection of Atrial Fibrillation (the most commonly preventable cause of stroke), Palpitation investigations, Transient Loss of Consciousness investigations (responsible for 6% of all A&E attendances), Stroke of unknown cause / Post Transient Ischemic Attack (TIA) investigations. Unsurprising then, that such a small, un-intrusive device is an essential weapon in a cardiologist’s arsenal.

Holter analysis requires considerable skill in reading ECGs to produce a precision report. Whilst the majority of this testing is done in hospitals, high demand, cardiac physiologist shortages and labour intensive analysis (1 hour per 7-day study) mean substantial waiting times and restriction of monitoring periods. Yet longer monitoring periods increase diagnostic yield; increasing the monitoring period from 24 hours to 7 days has shown to improve diagnostic yield by as much as 30%. However, 7 day monitoring is often not achieved either due to lack of physiologist resources or poor patient compliance. Patients do not like wearing cumbersome wired conventional Holter recorders and prefer the newer wearable patch type recorders.

Pre-COVID-19, waiting times for Holter monitoring of several months were not uncommon and in some UK regions, they extended to over a year. Post-COVID-19, the situation has deteriorated dramatically with the majority of cardiology hospital outpatient appointments cancelled or postponed due to the transfer of cardiac physiology staff to intensive care

units and the understandable reluctance to bring patients into hospital where there is a high incidence of Coronavirus infection.

Unfortunately cardiac disease has not disappeared because of COVID-19. It is now hidden.

That’s why, at Technomed, we have mobilised our response and service offering to include Holter monitors by courier to keep patient visits to the hospital or surgery to a minimum. This convenient ‘mail order holter kit’ consists of a pre-programmed Holter device, long-term hypoallergenic electrodes, skin-prep abrasive wipes, disposable razor and comprehensive instructions on how to apply. Patients can also rest assured that our all our kit is fully sanitised to denature the COVID-19 virus and other pathogens.

For convenience in general practice, we’ve even made this feature available directly from
SystemOne and EMIS Web patient records. Just select the mail order button on the ECG On-Demand Portal. The results will be returned electronically and our cardiologist is available if assistance is required.

For more information visit

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Please note NHS users must be connected to N3 to enable access to the NHS platform.

Existing customers please login to your ECG On-Demand® platform here.