When the arrhythmia occurs relatively infrequently and when occurs the symptoms do not last too long, most likely 24-48 hours of monitoring or intermittent monitoring will not be able to record the arrhythmia. At that point, we will consider a different type of continuous ECG monitoring called extended outpatient continuous monitoring. 

This can be achieved either by devices that use wires or by patch monitors. These monitors can be prescribed for 3 days up to 30 days; periods longer than that have been found cumbersome and impracticable by patients.

Both types of monitors continuously monitor each beat of your heart. They then either:

  1. Detect an arrhythmia automatically (regardless of whether it is symptomatic or asymptomatic) and make a recording whenever you press a button in association with symptoms (mobile cardiac telemetry)
  2. Make a recording only when an arrhythmia is detected or whenever you press a button while having symptoms (continuous loop recorders).

Consideration for which type of monitoring we use is mostly dictated by the insurance coverage. 

These monitors will be applied either in the office or they will be sent directly to your home along with simple instructions. You will attach the patch or the 3 electrodes and the wires. 

The patches are more convenient to wear but the wired monitors have the advantage of providing 3 channels of recordings to better distinguish the arrhythmia and decrease the amount of unusable data due to artifacts (electrical interference from outside sources.) 

The mobile cardiac telemetry monitors transmit data wirelessly every day, the loop recorders transmit over the phone when events are recorded and some patches are analyzed for arrhythmias after they are returned.