Holter Monitoring & Ambulatory ECG Flashcards
7 cards from real CET practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Holter Monitoring & Ambulatory ECG flashcards as text
A patient's Holter diary shows chest pain at 2:14 PM. The technician should first look for arrhythmias or ST changes in the recording at what time relative to the diary entry?
Answer: 5 minutes before and after 2:14 PM
Reviewing a window around the symptom time (before and after) captures both precipitating arrhythmias and resulting changes.
During Holter analysis, a technician notices the patient's heart rate drops to 28 bpm for 6 seconds during sleep. This finding is most consistent with:
Answer: Vagally mediated sinus pause, common during sleep
Brief nocturnal sinus pauses up to 2–3 seconds are a normal vagal phenomenon in athletes and during sleep; isolated pauses without symptoms are usually benign.
Which electrode placement error most commonly produces a wandering baseline artifact on a Holter recording?
Answer: Inadequate skin preparation before electrode attachment
Poor skin prep leaves oils and dead cells that cause high-impedance connections, resulting in wandering baseline artifact.
A 48-hour Holter report states 'total QRS complexes analyzed: 87,432 with 2.1% ventricular ectopy.' Approximately how many PVCs does this represent?
Answer: 1,836
2.1% of 87,432 ≈ 1,836 PVCs over the 48-hour period.
A patient returns a Holter recorder with only 18 hours of data on a prescribed 24-hour study. The BEST next step is to:
Answer: Note the incomplete recording and schedule a repeat study if clinically indicated
The technician should document the abbreviated recording duration and communicate with the ordering physician to determine whether a repeat study is needed.
On a Holter tracing, supraventricular tachycardia (SVT) is BEST distinguished from ventricular tachycardia (VT) by:
Answer: QRS width during tachycardia
Narrow QRS (<120 ms) during tachycardia strongly suggests SVT, while wide QRS (≥120 ms) suggests VT or SVT with aberrancy.
When applying Holter electrodes, the technician should clip chest hair rather than shave it. The primary reason is:
Answer: Shaving causes skin irritation that increases artifact
Shaving can cause micro-abrasions that irritate skin and may increase impedance or discomfort; clipping reduces hair without disrupting the skin barrier.