Holter & Ambulatory Monitoring Flashcards
7 cards from real CVT 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 & Ambulatory Monitoring flashcards as text
A Holter recording from an asymptomatic patient shows three consecutive PVCs at a rate of 120 bpm. How is this rhythm classified?
Answer: Non-sustained ventricular tachycardia (NSVT)
Three or more consecutive PVCs at a rate ≥100 bpm that terminates within 30 seconds is classified as non-sustained ventricular tachycardia.
What is the purpose of the patient event marker button on a Holter or event monitor?
Answer: To allow the patient to tag the recording at the time of symptom onset for correlation with the ECG
The event marker creates a time-stamped annotation so the technician can immediately locate and review the ECG strip at the moment the patient experienced symptoms.
In the context of ambulatory monitoring, what is 'circadian rhythm analysis' used to detect?
Answer: Time-of-day patterns in arrhythmia frequency, heart rate, and ST changes
Circadian analysis identifies time-of-day clustering of events — for example, the early morning surge in ischemic episodes or arrhythmias — which has prognostic and therapeutic implications.
A Holter technician needs to differentiate true atrial fibrillation from artifact. Which feature on the tracing BEST confirms AF is real?
Answer: Absent organized P waves with irregularly irregular RR intervals confirmed in multiple leads simultaneously
Genuine AF shows absent P waves and irregularly irregular RR intervals that appear consistently across all simultaneously recorded leads, unlike single-lead artifact.
When reviewing a Holter for ST-segment analysis, what is the standard measurement point for ST deviation?
Answer: 60-80 ms after the J-point
ST deviation is measured 60-80 ms after the J-point (the junction of the QRS and ST segment), which is the standard for ischemia evaluation.
A patient wearing an ambulatory blood pressure monitor reports the cuff inflated but gave an error reading at 3 AM. What is the MOST likely explanation?
Answer: Excessive arm movement or cuff displacement during sleep caused a measurement error
Movement artifact or cuff slippage during sleep is the most common reason for failed ABPM readings, and the monitor will log an error and retry.
What is the significance of a 'late potential' detected on a signal-averaged ECG (SAECG) in a post-MI patient?
Answer: It indicates areas of slow conduction in infarcted tissue that serve as a substrate for re-entrant ventricular tachycardia
Late potentials on SAECG reflect delayed, fragmented activation through peri-infarct scar tissue, creating a substrate for re-entrant VT circuits.