Wentworth-Douglass Hospital
(603) 742-5252
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Non-invasive Cardiac Testing

In the non-invasive cardiac testing section of the Cardiovascular Care Center, we conduct a variety of exams to include Electrocardiograms, 24-Hour Holter Monitoring, 30-day Loop type event monitoring, as well as various types of stress testing to provide your physician with the information needed to diagnosis your condition.

Electrocardiogram (EKG or ECG)

An electrocardiogram - abbreviated as EKG or ECG - is a diagnostic test used to detect abnormalities in the heart's rhythm. It can provide important information about damage to the heart, valve disorders, structural abnormalities in the heart's walls and more.

By measuring time intervals on the ECG, a doctor can determine how long the electrical wave takes to pass through the heart. Finding out how long a wave takes to travel from one part of the heart to the next shows if the electrical activity is normal or slow, fast or irregular. Also, by measuring the amount of electrical activity passing through the heart muscle, a cardiologist may be able to find out if parts of the heart are too large or are overworked. 

Preparation: None required.

Holter Monitoring

The Holter test is a scaled-down version of the 12-lead electrocardiogram (EKG) in that only a few leads are actually monitored. The test duration, however, is typically 24 hours, instead of the typical, several seconds required for an EKG.

Holter Monitoring is used as a screening tool in the evaluation of patients with symptoms of various forms of heart disease, or in situations where the physician suspects cardiac pathology in the absence of symptoms. Symptoms such as palpitations, lightheadedness or fainting may be caused by disturbances in the electrical signals that control the heart muscle contractions. These disturbances can be random, spontaneous, sleep-related, or emotion- or stress-induced.

Holter Monitoring is an ideal test because the patient assumes normal, daily activities, increasing the likelihood that he or she will experience the precise situations that can trigger symptoms or cardiac events. This allows correlation of any rhythm problems or abnormalities with activities and/or symptoms. In the opposite sense, Holter Monitoring can also be used to "rule out" cardiac causes of patients' symptoms if these symptoms occur in the absence of any cardiac event. 

The patient wears the battery-powered Holter Monitor, a device weighing a few ounces, on a belt or shoulder strap. Adhesive patches on the patient's chest conduct the electrical signals of the heart to the Holter Monitor through wire connections. The monitor, in turn, stores and analyzes the data. The patient wears the monitor for 24 hours and assumes normal activities, including sleep periods.

At the end of the 24 hours, the data from the monitor is transferred to the base station computer, where a licensed technician reviews and, if required, edits the data in a procedure known as "scanning". A report is generated that documents and trends any abnormalities that occurred and is submitted to the cardiologist for final interpretation.

Preparation: None required.

While wearing the device: Logbook entries will be required. No contact with devices that may disrupt an accurate tracing (i.e. electric blankets, massage chairs, etc.)

Cardiac Event Monitoring

Cardiac Event Monitoring is conducted on patients who report symptoms that may be cardiac in origin, and that occur infrequently-usually three times or less in one week. The term "Event Monitoring" is used because traditionally the test relied on the occurrence of symptoms, or "events"; that is, the patient activates the Event Monitor to record his/her ECG when symptoms occur. Monitors also have the ability to auto-capture events even if the patient does not feel the symptom to initiate the recording. The testing period can last up to 30 days, which means that the patient carries the Event Monitor for this length of time.

Cardiac Event Monitoring is used to evaluate patients who experience transient, infrequent symptoms that may indicate various forms of heart disease. Symptoms such as shortness of breath, dizziness and palpitations are some of the common patient complaints. These symptoms may be caused by disturbances in the electrical signals that control the heart muscle contractions. The disturbances can be random, spontaneous, or emotion- or stress-induced.

Patients carry the small, battery-powered Event Monitor for the duration of the testing period. The monitor may or may not be directly attached to the chest using wires and adhesive patches. The patient triggers the monitor to record the ECG when a symptom occurs. Monitors also have the ability to automatically capture clinically relevant ECGs, even if the patient does not feel a symptom. After the recording is complete, the patient transmits the ECG via phone to a Monitoring Center. The Monitoring Center staff reviews the tracings and notifies the patient's physician immediately, if appropriate. A report is generated and forwarded to the cardiologist.

Preparation: None required. It takes approximately 30 minutes to set up device.

Returning Device: A pre-payed envelope is used to return device.


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Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100