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Monitoring for Atrial Fibrillation in the Age of COVID-19

Monitoring for Atrial Fibrillation In the Age of COVID-19

This article is for people who have atrial fibrillation and will need to use a medical device for monitoring, or anyone who wants to learn more about atrial fibrillation. The goal of this patient education activity is to increase knowledge about different medical devices used to monitor atrial fibrillation.

You will learn about:

  • Signs and symptoms of atrial fibrillation

  • Why your doctor has recommended monitoring

  • Several medical devices used for monitoring atrial fibrillation

  • Whether having COVID-19 changes how your doctor will monitor your atrial fibrillation

  • What the results of monitoring mean

  • Questions to ask your doctor


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What Is Atrial Fibrillation?

Atrial fibrillation (“afib”) is a fast and irregular heart rhythm. It is caused by very quick and chaotic electrical impulses from the heart's 2 upper chambers, called the atria.

This can cause your heart to become weak and less effective at pumping your blood. Blood may then pool in the atria where it may form a clot that can lead to a stroke.

What Are the Symptoms?

You may have heart palpitations, which are rapid or irregular heartbeats, or the feeling of ‘skipping’ a beat. They can be mild or severe.

Shortness of breath and fatigue or feeling dizzy or lightheaded, may also occur because your heart is unable to push blood out of your heart effectively. You may not be able to exercise, or you may be active but tire more easily.

Fainting and/or unexplained falls and chest pain are also symptoms.

And sometimes you may not notice any symptoms.

Are Symptoms Dangerous?

Always call your doctor or seek medical help if you have any symptoms of atrial fibrillation.

Atrial fibrillation can cause a blood clot to form which can cause a stroke. Long-term atrial fibrillation may also cause heart failure.

Why You May Need a Monitor

A heart monitor is a device that records the electrical activity, or rhythm, of your heart. Looking at the electrical activity can help your doctor determine if you have atrial fibrillation. It’s also used for additional monitoring if you have been diagnosed and treated to make sure your treatment is working.

There are 2 ways that heart monitors can record your heart rhythm:

  • Continuous: this automatically records all the rhythms of your heart as long as you wear the monitor

  • Noncontinuous: this records the rhythm of your heart only when you notice you are having a problem and activate the monitor by pushing a button to capture the recording

Types of Monitors

A Holter monitor records your heart continuously for 24 to 48 hours. Your doctor will attach small electrodes to your chest. Wires connect the electrodes to a small battery-operated recorder you can wear around your neck.

Patches or event monitors record your heart’s activity noncontinuously (on and off) for up to 30 days. This means that you wear the heart monitor for up to 30 days, and you press a button to activate a recording of your heart’s activity when you have chest pain, dizziness, or palpitations.

An insertable monitor is placed just under the skin on your chest in a simple office procedure and records your heart continuously. Some can work for up to 3 years.

Other monitors work with a smart phone app.

Dr Bharath Reddy talks about the types of heart monitors used to record your heart’s electrical activity.

How Long Do You Need a Monitor?

That depends on how often you have symptoms. Different monitors are worn for different lengths of time.

If you experience symptoms often, a Holter monitor may be able to catch your heart’s abnormal rhythm within a few days.

If your symptoms are less frequent, you may need to wear a monitor longer to make sure that it records your symptoms when they happen.

Your monitor will record your symptoms whether or not you notice them.

Dr Bharath Reddy talks about the length of time you may need to wear a heart monitor.

Wearing a Monitor

You might think that you need to limit your activities while wearing a heart monitor, but that’s not true. In fact, you should be encouraged to continue your regular routine so your doctor can better understand how your heart reacts to the different things you do throughout the day.

If you have an insertable device, you can swim, bathe, and exercise as normal. If you have a Holter monitor, patch, or event monitor, you will have to remove the patch or electrodes from your skin while swimming or bathing.

Has the COVID-19 Pandemic Changed Monitoring?

No. Always remember that it’s important to follow the directions that your doctor gives you when using your device.

If you are using an insertable monitor, it can transmit the recordings of your heart directly to your doctor's office. This allows your doctor to check your heart's rhythm whether or not you are there in person. You do not need to go to the office.

If you have a telemedicine visit with your doctor, make sure you have the correct information to join the meeting via computer or phone so you don't miss your appointment.

If you are going to your doctor's office for a visit, follow your doctor’s office instructions for your visit (social distancing, waiting in your car, mask wearing, etc.). It is important to keep all your follow-up appointments. You do not want to wait to have your heart monitored or wait for the results. This could delay getting any follow-up care you might need (any prescription medicines or additional tests).

What Do the Results Mean?

The meaning of the results will vary from person to person. Your doctor may be able to tell right away that you have an abnormal heart rhythm. This means you can get the treatment you need to get better or manage your symptoms.

If the recording doesn’t give your doctor enough information, you may need to wear a heart monitor for a longer period of time.

Questions to Ask Your Doctor

  • What are the symptoms of atrial fibrillation?

  • What kind of heart monitor do I need to use?

  • How long do I need to wear the heart monitor?

  • What do the results mean?

  • Does COVID-19 change the way I use a heart monitor?

  • Can I still do my regular activities?

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You have successfully completed the program: Monitoring for Atrial Fibrillation In the Age of COVID-19

View Additional Materials

View Additional Materials on this topic that you may find useful:

National Heart, Lung and Blood Institute: Atrial Fibrillation

CDC: Atrial Fibrillation

Authors and Disclosures


Bharath Reddy, MD

Disclosure: Bharath Reddy, MD, has disclosed the following relevant financial relationships:Served as an advisor or consultant for: MedtronicServed as a speaker or a member of a speakers bureau for: Abbott Medical; Biosense Webster; Boston Scientific; MedtronicReceived grants for clinical research from: Abbott Medical; Boston Scientific

Clinician Reviewer

Susan L. Smith, MN, PhD

Senior Medical Education Director, Medscape, LLC

Disclosure: Susan L. Smith, MN, PhD, has disclosed no relevant financial relationships.


Heather Lewin, MAT

Associate Director, Medscape, LLC

Disclosure: Heather Lewin, MAT, has disclosed no relevant financial relationships.


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