Holter Monitoring

A Holter monitor is a portable electrocardiogram (EKG) machine that records and stores a patient’s heart rate and rhythm over a 24-hour period (or longer). The Holter monitor records EKG changes that occur sporadically; those changes that are difficult to capture at an appointment. Doctors review tracings recorded at times when symptoms are noted.

How It Works

The Holter monitor is a portable EKG recording device that is worn during daily activities, including sleeping. It has a strap that is worn over the shoulder or around the waist. It is battery-powered and records data onto a regular-sized cassette tape. The monitor’s wire leads attach to sensitive, sticky-backed electrodes, which adhere to the patient’s chest to detect the heart’s electrical impulses. The impulses are recorded to create a 24-hour record.

What To Expect

Holter monitoring is painless. It must be fitted and applied at the doctor’s office. After it is fitted, it cannot be worn in the shower or bathtub. A nurse cleans the skin and applies 5 to 7 electrodes to the chest. For men, small areas of hair may need to be shaved from the chest. The monitor is worn for 12 to 24 hours. While wearing the monitor, the patient is asked to keep a log or diary of daily activities and symptoms, including fluttering feelings in the chest (palpitations), rapid heartbeats, shortness of breath, and any episodes of dizziness or faintness. It is also important to keep track of the activity that might have initiated the symptoms. The diary helps the doctor determine which activities might cause any abnormal readings. Patients should do typical activities, except those that might get the Holter monitor wet. After 24 hours (or more), the patient returns to the doctor’s office to return the monitor and remove the electrodes. A technician plays the tape on a special computer that analyzes the recording and looks for any abnormalities of the rhythm. The technician prepares a full report for the doctor, including a printout of any abnormal heart rhythms that were captured.


Resources

Texas Heart Institute www.texasheartinstitute.com/HIC/Topics/Diag/diholt.cfm
The Cleveland Clinic www.clevelandclinic.org/heartcenter/pub/guide/tests/electrocard/ambmonitor.htm