Event Monitoring is the traditional form of Cardiac Monitoring beyond the 24-48 hour Holter Monitoring study. In theory, Event Monitoring is designed to capture cardiac events over an extended period of time ranging from 3 days to 3 years.
Event monitoring has evolved over the years with various forms of technology. In the past, there has been the traditional “Looping” event monitors designed to capture symptoms felt or detected by the patient. Now, there are new Event Monitoring technologies that are automatic in detecting & store cardiac events regardless of whether the patient felt the symptom or not. Further, there is cardiac event monitors technology that that (not only) automatically detects, but also automatically transmit symptoms via cellular technology to a diagnostic laboratory for analysis. Most recently, there has been significant advancements in implantable technology that is indicated for an extended period of time to assess a greater picture in cardiac rhythm management (CRM).
Event Monitoring can encompass the following:
- Looping recorders designed to capture symptomatic events (only)
- Post Event Monitors
- Auto-Trigger (automatically detect and store) cardiac events
- Auto-Trigger, Auto-Transmit (via cellular technology)
- Mobile Cardiac Telemetry
- Implantable Cardiac Event Monitors
Looping Symptomatic Event Monitoring Recorders
Event Monitors are also known as ‘Loop Recorders’ as the devices are constantly recording the specified period but not saved until the “Event Button” is pressed by the patient. For example, if a patient is wearing the event recorder and the patient experiences an event, the patient depresses the event button and the recording device will record and save only 30 seconds prior to the event and 60 seconds after. The device can generally be programmed to adjust the recording period if so desired by the physician.a week to 30 days. Event Monitoring utilizes a small device that is programed to record a specified period before the event and after the button is depressed by the patient. The patient is then either instructed to transmit that recorded event via telephone to a call center or leave the transmission / download at the end of the study period.
Post Event Monitoring Recording Devices
Post Event Monitoring are the most simplistic form of cardiac event monitoring. This device is simple in that it is generally small in size & weight as the only function of the device is to record upon activation by the patient. These devices are proven to be useful as a patient can carry on them at all times and place on the chest to record a symptomatic event should one occur. These devices store the event for a transmission at a later time generally via land line or internet connection.
Auto-Trigger (and store) Event Monitoring Recorder
Auto Trigger Cardiac Event Recorder is the next phase of cardiac event monitoring in that it has an auto detect feature to assist in capturing the cardiac abnormalities. This technology is useful as it can automatically capture and record cardiac arrhythmias that go undetected by the patient. These devices store these events for a later time where the data is transmitted to the diagnostic laboratory via land line, internet connection, or returned to the medical facility for download.
Auto Trigger, Auto Transmit Event Monitoring Recorders:
This form of cardiac event monitoring is similar to Mobile Cardiac Telemetry in that it automatically detects and automatically transmits cardiac arrhythmias to the diagnostic laboratory. This transmission can be patient activated or performed in real time. What separates this form of Cardiac Event Monitoring from MCT is these event recorders do not have the capability to record & store all 30 days of continuous ECG information making the device not applicable for use for Mobile Cardiac Telemetry.
Mobile Cardiac Telemetry Monitoring
Mobile Cardiac Telemetry (MCT & MCOT) monitors are the most advanced form of ambulatory cardiac monitoring technologies. Mobile Cardiac Telemetry automatically detects and automatically transmits ECG data to a diagnostic laboratory in real time. This capability essentially makes all other forms of monitoring obsolete as this can reduce the monitoring time and provide physicians with a much quicker diagnosis compared to other short & longer term monitoring modalities. With this being the case, many experts believe Mobile Cardiac Telemetry can be the most useful form of monitoring because it enhances the diagnosis with a huge potential for reducing healthcare costs.
Implantable Cardiac Event Monitors
Implantable Cardiac Event Monitors (ICM) are by far the least utilized form of Cardiac Event Monitoring. Implantable Cardiac Event Monitors are required to be surgically implanted in the patient making this the least attractive option of all forms of Cardiac Event Monitoring. In addition, the case of an implantable device is extremely rare as other forms of non-invasive cardiac event monitoring technologies can capture the necessary information in less intrusive, more cost effective manner. However, there are the few clinical scenarios that would require implantable cardiac event monitors as they have some superior diagnostic capabilities for long term monitoring.