The first step is simply to find out if you have AF. If you don’t, then you don’t have to worry about it. That’s not to say that it’s impossible to have palpitations or fainting or a stroke from something other than AFib. But if you don’t have AF then your chances of having any of those things is much lower. The main way to check if someone has AF is to check either their ECG, which measures the electrical activity of the heart and can see if the electrical activity is normal or fibrillatory, or to check the pulse and see if its irregular. If and ECG shows normal synchronized electrical activity or if the pulse is regular, then you don’t have AF. The trouble with AF is that it can come and go. In other words, the electrical system of the heart can be normal sometimes and disorganized/fibrillatory at other times. We call this paroxysmal atrial fibrillation. A paroxysm is just a fancy word that means an episode. Paroxysmal AF is just the medical term for episodic AF. The trouble with that is that just because your pulse is regular at the time you check it, it might not be regular at other times when you’re not checking it. And even with paroxysmal AF, or PAF, there is still a chance of having a blood clot in the atrium and therefore a stroke. This means that when someone is suspected of having AF or PAF, they must be monitored for a very long time. Usually people are monitored for either an entire day, sometimes an entire week or two. Sometimes people need to be monitored even longer, up to even a few years.
A more advanced type of cardiac event monitor is called an MCT monitor, or mobile cardiac telemetry monitor. This is very similar to a holter monitor in that it has the same box, wires, and stickers. The main difference between a regular holter monitor and an MCT is in the technology inside the box. The MCT monitor has an antenna inside the box which is connected usually through a cellular data network so that a monitoring center can see the data in real time as it is collected. This means that an MCT monitor can give real time data and can be configured to send your doctor alerts in real time if an abnormal rhythm is detected. MCTs suffer from the same wearing restrictions that holter monitors do, however, such as avoiding sweaty activities, avoiding water, general bulkiness, and difficulty with sleeping.
Modern technology has allowed a variety of sensors to be constructed in a very small size. This has allowed for accurate monitoring of the pulse as a way to detect abnormal heart rhythms instead of monitoring the electrical signals in the heart itself. This means that the trade-off made by the patch-type monitors and ILRs no longer has to be made. Recall that because the patch monitors and ILRs don’t have any wires they only can see the equivalent of a single electrical lead. If the signal is not good in that lead, they are stuck, and their accuracy is reduced. They made that sacrifice for the sake of convenience. With pulse-type monitors, that sacrifice doesn’t have to be made. Pulse monitors are small devices that measure one’s pulse and therefore don’t rely on electrical signals or leads.