Veterinary Medicine - January 2008 - (Page 34)

Holter monitors PEER-REVIEWED 2. Selected Holter monitor ECG rhythm strips demonstrating atrial ﬁbrillation. The top rhythm strip (three leads) was obtained in the hospital shortly after applying the Holter monitor. Note the rapid ventricular rate (210 beats/min). The rhythm strip at the bottom was recorded in the patient’s home environment. Note the slower ventricular rate (73 beats/min). monitor can facilitate the diagnosis of pacemaker malfunction by recording the patient’s rhythm over 24 hours or more during daily activities. TECHNIQUE Holter recorders are available with three to ve electrodes. Holter recorders with ve electrodes improve the ability to differentiate movement artifact from pathologic arrhythmia and VPCs from supraventricular premature contractions. However, Holter recorders with three electrodes are easy to apply and usually provide suf cient data (Figure 3). If you carefully apply and secure the electrodes, you will almost always obtain high-quality Holter recordings. It is critical to have excellent contact between the electrodes and the skin. To that end, clip the hair down to the skin at the sites of electrode attachment. Scrub the skin vigorously with a solvent, such as acetone, and allow it to dry. Apply adhesive electrodes, and wrap them tightly with 2-in elastic tape (Figure 4). When the electrode-skin contact is rm and wrapped tightly to prevent electrode movement, you will obtain a high-quality recording during both quiet and active periods. Even vigorous activity is usually not associated with excessive artifact. Because the electrodes are applied securely, removal can be challenging. We do not recommend using sharp utensils such as scissors and scalpel blades to remove the elastic tape; you might accidentally cut the leads or the patient. Instead, we recommend carefully applying acetone or a commercial tape adhesive solvent to the elastic tape and electrodes. Avoid contact with the Holter monitor and ash card. If you destroy the adhesive material rst, Holter recorders can be removed safely and painlessly. Holter monitor services Holter monitors can be obtained from and the data analyzed by numerous Holter scanning services. Although these services use modern systems capable of arrhythmia analysis, remember that they are not designed for canine 34 January 2008 VETERINARY MEDICINE

Table of Contents Feed for the Digital Edition of Veterinary Medicine - January 2008

Veterinary Medicine - January 2008 Contents Digital Extra Letters Toxicology Brief Idea Exchange A Challenging Case: Phimosis in a Young Adult Dog The Indications and Technique for Continuous Ambulatory Electrocardiographic Recording in Dogs A Review of Selected Systemic Antifungal Drugs for Use in Dogs and Cats CE Form Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - January 2008

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