Misadventures in cardiac event monitoring.

I went to the cardiologist a few days ago. My blood pressure is still at about 140/80-90. He said the the funky things my GP saw on my 12-lead EKG were "normal variants." I had another 12-lead EKG taken in his office, without any abnormalities.

So he scheduled me for a stress echo (like your run-of-the-mill stress test, but I get my heart echo'd before and right after also) and set me up for a month of "cardiac event monitoring." Little did I know all the highly irritating, hilarious and fascinating things I was about to experience.

A cardiac event monitor is very similar to a Holter monitor. It's a constantly monitoring 2-lead EKG that records selectively. I have 2 leads on my chest that are connected by wires to this pager-looking/sized black device. It's constantly monitoring my heart, but only records when I press a button or when my HR goes over 150 or under 40. The 60 seconds prior to the trigger and the 30 seconds after are recorded and stored in the device as "events." The device can record up to 3 events, which are then transmitted VIA phone to some technicians at some company who send the short strips to my cardiologist. To do this, I call them from a land line, tell them about my symptoms during the event, and put the mouthpiece of the phone and press a button to send. The pager-ish device proceeds to make a scary fax machine screechy noise for several minutes and that's it. Then the events are cleared and the fun starts all over again. This article describes the whole cardiac event monitor thing in more detail.

I'm supposed to press the record button whenever I have palpitations, but in the 2 days that I've been wearing the damn thing I've yet had the need to do so. However, it's set itself off due to tachycardia about 6 times, despite the fact I haven't really done anything physically strenuous.

I put it on for the first time on Thursday morning, right before going to work. It managed to set itself off from tachycardia twice by the time I made it to the clinic, and unfortunately it makes this loud intermittent beep as long it has any events recorded on it. So I walk into the clinic with wires hanging out of the bottom of my scrub top mystically making electronic beeping noises every minute or so. To stop this beeping I had to borrow the attending's land line to call that number to transmit, so my boss had to endure about 5 minutes of me talking on her phone and 8 minutes of annoying screechy fax machine noises. Thank god my boss is a doctor, because I think most other bosses would have fired me at this point.

Today was even worse. There was a different attending on today, so I had to explain, again, why wires were dangling out of my top and why I kept beeping. This time, I had 3 events by the time I got to work. So I borrowed the attending's phone again to transmit, but this time the entire world must've been having palpitations because I was on hold forever. So long that I kept having to hang up to go take care of patients, come back, try again, wait on hold, and repeat. Over and over and over again. And every patient was looking around the exam room trying to figure out where that damn annoying beeping was coming from while I was trying to talk to them. Finally I got through to the tech to transmit and the beeping ceased.

Later in the day I was assisting the attending and a 4th year medical student with minor surgery.. basically being the scrub tech instrument passer. All of a sudden they desperately needed this tubing, and it wasn't in the room. So I dart out the door and I'm running around the clinic like a bat out of hell flinging open cabinets trying to find it. I find it, bring it back to them, but it's the wrong kind. I again run around the clinic like crazy trying to find that damn tubing. Unfortunately, we're out of the right kind. I return to the room in defeat to find them continuing the procedure Macgyver style. And I hear that damn beep. The patient looks confused as they finish her procedure to the lovely tune of...

BEEP!................................ BEEP!........................... BEEP!............................. BEEP!............................ BEEP!...............................

Later I discharge her from the clinic to the same glorious melody. I apologize, but decide not to explain. Don't want her thinking I'm terminally ill AND nuts.