Advice On Preparing For A 24 Hr Ecg/holter Monitor

[flyingsquirrel]

When I rang the Blood Pressure Association to ask about Holter monitors since I'd heard of them here, they said, "Oh yes, that means an ECG. No one says Holter monitor any more, it's a a very old name!" We are two nations divided by a common language, as someone or other said.

I'd heard somewhere that EKG was used because ECG had already been snaffled for something else in the US, though I can't remember what.

Yes, that's what I thought ECGs did. I'm not quite sure why someone mentioned BP. I didn't realise that they didn't all print out a graph, though. Surely you can't notice the whole >30bpm rise on standing unless you have a proper graph?

Lots of people on the side of the pond still say Holter monitor (named after Norman Holter) although the modern name of the test is 24 (48, etc) hour ambulatory ECG/EKG monitor.

ECG/EKG refers to the broad range of tests that look at eletrical rhythms of the heart from single lead rhythm strips, to 12-lead diagnostic quality printouts, to Holters, telemetry, event monitors, etc.

ECG=EKG. It doesn't mean anything else in medicine. (unless you are a veternarian...then it can mean equine chorionic gonadotropin...or so says wikipedia.)

Even if the graph is not a part of the official report, the data is still there and your physician can access it. They could look through all 24 hours of EKG tracings if they wanted to.

[kitt]

Good luck with the 24 holter monitor. I just wore one for two weeks, and that was a pain. Don't think you'll mind it for 24 hours.

Am NOT giving medical advice, but anti-histimines could well impact your readings. All forms of POTS have a strong mast cell connection, and some forms far more than others. Obviously, anti-histimines inhibit mast cells from releasing histimines, so give that some thought.

Good luck!

[Batik]

I still don't know exactly how histamine works with regard to POTS. I tried a couple of days off the antihistamines, and got almost no sleep and very peculiar home TTT readings. I'm not sure it's worth doing, especially since I'm already worried about the risk of collapsing when I go to hospital to get the stuff put on/taken off. (Well, maybe skip one dose the night before.) Thankfully my GP isn't relying on this test to get me referred to the specialist, so I'm less worried about it now. I assume the specialist will want me to be off the meds when she does the proper TTT testing, but then she sounds good enough to work around this sort of thing, and will know what to do about it all.

[yogini]

I would ask the dr whether to change your meds. Each med works if fervently and for some of them you might ave to be off or a few weeks to be sure they are out of your system. If you are having symptoms with the meds the. It shouldn't matter you are on them. I would not wear compression while on the test.

By the way I am not sure there is a mast cell connection with all forms of POTS. I don't have any mast cell/allergy type issues

[Batik]

I'll ask the doctor, but she isn't interested in the mast cell side of things, I think I'll need to see the specialist before that gets looked into, so she doesn't think the antihistamines are a big deal. I'm also worried about the risk of coming off them, since I'm ill enough that sleep deprivation can cause serious risks for me, especially if I have to make two hospital trips. Did you mean to type something else instead of "fervently"? I couldn't really make sense of that bit.

I discussed compression stockings with my GP and she's not going to prescribe them just yet. This is partly because they will probably just itchy like mad due to the dermographism, and partly because I'm not strong enough to put them on and take them off myself, my support workers are only in once a day right now, and apparently you shouldn't wear the stockings at night.

[kitt]

POTS does have a mast cell connection...not just in the hyper form. Most people aren't aware it.

A woman who is a doctor and disabled by POTS does a lot of videos and explains the mast cell connection. I prefer to read articles by Dr. Grubb and Dr. Raj, (who acknowledge it also), but this woman does a LOT of videos and explains things.

http://prettyill.com/videos/watch/my_mast_cell_week_how_was_yours

You might want to watch some of her videos on POTS.

[NMPotsie]

Prior to my tilt I was told not to take a variety of meds, including antihistamines. This link might help, though I would still talk to your doctor. http://www.neurology.upmc.edu/neuromuscular/patient_info/testing.html

[Angela]

What's a 3 read hr bp cuff? Did you have a 24 hour ambulatory blood pressure test run?

it's just a cuff that shows your sys/dia and pulse. I use the omron BP710, my neuro uses the omron as well, they have found it to be the most accurate. You probably already have one just wasn't sure my abbreviations? No, I never had a 24 hr ambulatory blood pressure test, I have woken up at night to see what my bp is doing but it is always kosher at night, just fluxes in the day when I am active.

And.....I have never had symptoms of allergies, never been to an allergist or tested for mast cell anything but taking H1's and H2's has somehow improved my symptoms. I still have tachy and bp spikes but I think that got worse after I stopped taking the bb I was on, afterwards my spikes were higher than ever.

[Batik]

Oh, you just meant an ordinary blood pressure monitor! Yes, I've got one of those already. I thought the "hr" meant "hour", not "heart rate", so I was assuming it was some sort of ambulatory monitoring system.

I'm increasingly showing allergy-type reactions, which is very odd. Yesterday I had a horrible reaction to lunch (I suspect the black garlic as a culprit) and still haven't recovered from the itchiness.

[Batik]

The appointment is through, and it's for 4 and 5 December. I've managed to book transport from the Red Cross. After doing some more tests, I reckon I should come off the antihistamines beforehand, as I'm on quite a few by now (they added in cimetidine after the attack I mentioned in the last post), and my HR magically doesn't go anywhere much when I stand up now, at least not with tests I've run recently. (So now I should do another, just to be sure!) Last time I came off the antihistamines, I just stopped cold turkey and promptly stopped sleeping. So my questions are:

a) How long do antihistamines stay in the system for? I need to work out when I should be completely clear of them for the test.

How slowly should I come off them? I'm currently on 10mg cetirizine, 10mg alimemazine, and 400mg cimetidine. Plus vitamins and minerals type stuff, which shouldn't make me feel particularly bad when I come off them.

My doctor hasn't a clue, nor has the cardiology department, so there's no point in asking them again.

[flyingsquirrel]

Here are the half lives of the meds you listed:

cetirizine - 8 hours

cimetidine - 2 hours

alimemazine - 5 hours* (I don't have a good reference for this as it isn't avaliable in the US)

After one half life, 50% of the last dose will be out of your body. After two half lives, 75% of the dose will be out of your body. Three half lives, 87.5%, etc.

[Batik]

Alimemazine is called Vallergan in the US, I think.

So I should be OK if I am down to no cetirizine or alimemazine 24 hours beforehand, and no cimetidine two days beforehand? And presumably taper down to those, maybe going down to half a tablet and taking one med at a time? I think the alimemazine is the most sedating, so I should probably come off that last. Although when I collapsed at the dermatologist that time, the only thing I was on was cetirizine, and I had been feeling awful due to stopping that a few days earlier. Obviously I want my symptoms to show up well, but I don't want to be collapsing at the hospital. I'm due to be premenstrual around that time too, which means more chance of anxiety, generally feeling cruddy, and judging by this month (the cimetidine has done a number on me), the munchies!

[StandUpSitDown]

One thing I want to clear up, as I didn't check this thread after I made my post a few weeks ago.

The Zio Patch from iRythm *does* record every heart beat. The report it gives also shows 'detected event's from their computer analysis of the recording. But it will also pay special attention to the times you push that EVENT button. But it is indeed a RHYTHM monitor - it shows when beats occur - it doesn't show anything more than that, and it cannot produce the kind of charts a multi-lead holter can.

[AllAboutPeace]

I recently took my son for allergy testing and they won't do the test unless you've been off antihistamines for a minimum of two weeks. I realize this would have a different sensitivity level, but they consider that the meds take that long to fully clear the system. I can't attest to the accuracy of that, but that is what I was told.

I hope things go well for you.

[Batik]

Thanks, that's good to know. In that case I should start tapering down now.

[Batik]

Arggh. Even doing no more than cutting the alimemazine in half and taking everything else, I slept really badly. Which could of course be partly due to expecting to sleep badly when off the antihistamines, but still. The week that I'm tapering off everything will be fairly rough: I think I will take valerian this week, and then don't take anything at all for the two weeks before the ECG. I hope that will work out.

Edited November 15, 2012 by corina