Ambulatory ECG Monitor Interpretation Report (Holter/Event/Patch)

Ambulatory ECG Monitor Interpretation Report

Patient: [Patient full name] • DOB: [DOB] • MRN: [MRN]
Ordering Clinician: [Ordering clinician name] • Interpreting Clinician: [Interpreting clinician name, credentials]
Report Status: [Preliminary / Final] • Study Type: [Holter / Patch / Event monitor / Mobile cardiac telemetry]
Device: [Manufacturer and model if known] • Order/Accession ID: [Order or accession ID]

Indication

[Primary reason for monitoring with relevant clinical context] (One to three sentences. Include known arrhythmias, structural heart disease, key medications, and presence of pacemaker/ICD when available. If no indication provided, state: "Indication not provided; interpreted for rhythm and arrhythmia assessment.")

Monitoring Details

• Monitoring modality: [continuous / intermittent] • Activation: [patient-activated / auto-triggered / both]
• Prescribed duration: [Prescribed monitoring duration] • Actual duration: [Actual monitoring duration]
• Start: [Start date/time] • End: [End date/time]
• Total recording time: [Total recording time] • Total analyzable time: [Total analyzable time] ([Percentage]%) (If not provided by vendor system, state explicitly.)
• Leads/channels: [Number of leads/channels]
• Patient-triggered events: [Count]
• Symptom diary: [provided / not provided]
• Event monitor enrollment window: [Enrollment dates] • Transmissions: [Count] (Include only for event monitors.)

Data Quality

Overall quality: [adequate / limited / poor]. [Key limitations and clinical implications] (Note artifact burden, lead loss, incomplete wear time, time synchronization issues, or lead configuration limits. State clinical impact when relevant, e.g., "Artifact may reduce sensitivity for brief atrial arrhythmias." If artifact metrics not provided by vendor, state explicitly.)

Findings

Predominant Rhythm

• [Predominant rhythm] (Include baseline conduction abnormalities if confidently identified.)

Heart Rate

• Minimum: [Min HR] bpm • Maximum: [Max HR] bpm • Average: [Average HR] bpm (Include context such as sleep or activity if available.)
• [Rate control assessment] (Include only if atrial fibrillation observed.)

Atrial Arrhythmias

• PAC burden: [Count and/or percentage]
• SVT/atrial tachycardia: [Number of runs], longest [Duration or beats], fastest [Rate] bpm (Include only if observed.)
• Atrial fibrillation/flutter: [present / absent]. (If absent and AF evaluation was part of indication, state: "No atrial fibrillation or flutter detected.") If present: [Total burden percentage], longest episode [Duration], [Episode count] episodes.

Ventricular Ectopy

• PVC burden: [Count and/or percentage], [unifocal / multifocal] (Note if morphology indeterminate due to lead limitations.)
• Couplets: [Count] (Include only if observed.)
• NSVT/VT: [Number of runs], longest [Duration or beats], fastest [Rate] bpm, [sustained / nonsustained] (State definition used. Note high-risk patterns such as R-on-T if observed.)

Bradyarrhythmias and Pauses

• Longest pause: [Duration] at [Timestamp] • Pauses ≥[Threshold]: [Count]
• AV block: [Type / none identified] (Include junctional escape if relevant.)
• (If bradycardia/conduction evaluation was part of indication and none found, state: "No significant pauses or conduction abnormalities detected.")

Symptom Correlation

• [Timestamp]: "[Patient-reported symptom]" — Rhythm: [Rhythm at event] — Correlation: [correlated / not correlated / indeterminate]
• (Repeat for each symptom or triggered event. Explicitly document negative correlation when symptoms occurred without arrhythmia. Note if clock synchronization issues limit correlation.)

Optional Analyses (Include only if performed and clinically relevant; note method limitations.)

• ST-segment analysis: [Summary and limitations]
• QT metrics: [QT/QTc values, measurement method, and limitations]
• Heart rate variability: [Method and summary metrics]

Impression

1. [Predominant rhythm with heart rate summary]
2. [Clinically significant arrhythmias with quantified burden] (Include both atrial and ventricular findings.)
3. [Clinically significant bradyarrhythmias or pauses] (Omit if none.)
4. [Symptom correlation conclusion]
5. [Study adequacy and diagnostic confidence] (Note impact of data quality or limited wear time if relevant.)
6. [Comparison to prior monitoring] (Include only if prior study available and comparison is clinically relevant.)

Recommendations

• [Actionable recommendations tied to specific findings] (Include medication considerations, referrals, additional testing, or follow-up interval only when warranted.)
• [Safety guidance regarding driving or machinery] (Include if syncope/presyncope occurred with concerning rhythm.)
• (If anticoagulation is considered, note that clinical stroke risk assessment is required beyond monitor data alone.)
• (If no urgent findings and no specific recommendations needed, state: "No emergent arrhythmia detected; correlate clinically and follow up as planned.")

Urgent Findings

(Include this section only if urgent findings were identified OR organizational policy requires documenting absence of critical results.)

• Finding: [Urgent arrhythmia] • Identified: [Date/time]
• Notification: [Name and role notified], [Method], [Confirmation of communication]
• Patient instructions: [Instructions provided if applicable]
• (If no urgent findings and attestation required, state: "No critical results requiring immediate notification.")

Interpreter Attestation

Interpreting Clinician: [Name, credentials]
Signature: [Electronic signature]
Date/Time Finalized: [Timestamp]

I have reviewed the recorded data and representative tracings and agree with the above interpretation.