You have been fitted with a cardiac monitor to look at the rate and rhythm of your heart over a period of time. This may be because you have been experiencing symptoms such as palpitations, dizziness, or blackouts or simply to provide further information to doctors to help make decisions about medication.
Please DO:
- Perform your normal range of daily activities when wearing the monitor.
- Record the symptoms currently being investigated by your clinician in the diary (separate sheet) using the time from the recorder.
- Keep the monitor dry, clean and in an undamaged condition and return at the time you have been requested to. The recorder is used on other patients directly after its return and failure to return will delay their treatment. It will also delay your results from being processed.
- Return this symptom diary even if you do not experience a symptom.
- Return you monitor to the site that it was fitted at the time you have been told to.
Please DO NOT:
- Change the battery or tamper with the recorder.
- Take the recorder into the bath or shower or submerse it in water.
- Remove the electrodes unless you are showering or swimming. For all tape duration’s 72 hrs or less, it is advised to refrain from traditional showering and bathing and to instead use a wash down method as to prevent the recorder from being taken off and re-applied incorrectly.
On return of your monitor, your heart rate and rhythm will be analysed and the results passed to your requesting clinician.
Patient Details
| Patient Name: | |
| Hospital Number: | |
| Date of Birth: | |
| Clinician: | |
| Clinician Dept. & Site: | |
| Date Fitted & Duration | |
| Return Date: |
Patient Symptom Diary
| Date | Time on Recorder | Activity | Symptoms |
| EXAMPLE Mon 10th June | 14:43 | Shopping | Palpitations |
*If you do not experience symptoms whilst wearing the monitor please leave the diary blank.