You can generally get a standard diagnostic X-ray while wearing an external heart monitor, though certain precautions are necessary. An X-ray is a form of electromagnetic radiation used to create images of structures inside the body. The energy levels used for standard diagnostic imaging are typically low, and this momentary exposure usually does not harm the electronic components of modern external cardiac monitors. While the monitor itself is safe, the primary concern is ensuring the X-ray procedure provides a clear image and that the monitor’s data recording is not interrupted.
Defining Types of Cardiac Monitors
Cardiac monitoring devices fall into two main categories: wearable and implanted. Wearable or external monitors are temporary devices used to capture the heart’s electrical activity over periods ranging from 24 hours to several weeks. These include Holter monitors, which use wires and electrodes attached to the chest connected to a small recording unit worn on a belt.
Newer wearable options often come as ultraportable, single-use adhesive patches that stick directly to the chest for extended monitoring. These devices are designed to be worn during normal daily activities to detect intermittent rhythm abnormalities. They are easily removable by a clinician once the monitoring period is complete.
Implanted devices, such as pacemakers and implantable cardioverter-defibrillators (ICDs), are surgically placed under the skin for long-term use. While these devices require stringent safety considerations for procedures like MRI, standard X-rays are safe. The metal casing of an implanted device creates a shadow on the X-ray image, which the radiologist must consider for accurate interpretation.
How X-Rays Affect Wearable Devices
Standard diagnostic X-rays use ionizing radiation, but the energy dose and duration of exposure are extremely brief and low. This low-dose energy is not sufficient to cause damage to the casing, wiring, or electronic circuitry within a modern wearable cardiac monitor. The circuitry is generally shielded and robust enough to handle the transient exposure.
X-rays do not affect the device by generating a strong electromagnetic field. Unlike an MRI, which uses powerful magnets that can interfere with medical electronics, an X-ray machine operates using different physics that pose no magnetic risk. This distinction explains why X-ray interaction is less of a concern than other imaging modalities.
The digital storage components in current heart monitors are highly resistant to low-level radiation. While high doses of radiation can potentially corrupt data, diagnostic X-ray exposure is far below this threshold. The likelihood of the X-ray erasing or corrupting the stored heart rhythm data is negligible.
A temporary concern is potential interference with the monitor’s reading during the X-ray exposure itself. The pulse of radiation can sometimes create an artifact in the recorded data, appearing as a brief spike or interruption in the heart rhythm tracing. This is a momentary distortion of the recording, not a sign of device failure, and it does not affect the overall diagnostic value of the long-term recording.
Necessary Steps Before Your X-Ray
The most important step before undergoing an X-ray is to inform the technician and the ordering physician that you are wearing an external cardiac monitor. This ensures the imaging team is aware of the device’s presence and can prevent image obstruction or data interference. Never assume the medical staff knows about the monitor.
If the X-ray is of the chest or abdomen, the electrodes or adhesive patch may appear as an opaque shadow on the image. This shadow can obscure the underlying anatomy, potentially hiding an area of concern. The technician may need to temporarily reposition or remove the specific electrodes or the entire patch that is directly in the path of the X-ray beam.
The recording unit of a Holter monitor should generally be moved away from the direct X-ray path if possible. If the monitor’s wires or patch must be detached, this should only be done with instructions from the imaging staff to ensure the device is safely paused and not damaged. Patients must know how to reattach or reactivate the monitor correctly after the scan.
Following the X-ray procedure, patients should check the monitor’s indicator lights to confirm it is still powered on and actively recording data. Most modern monitors have a visual signal, such as a blinking light, to indicate continuous operation. If the monitor appears to be off or malfunctioning, immediately notify the imaging staff or the cardiac monitoring provider to ensure the integrity of the remaining test period.