Holter Monitoring

Holter Monitoring

A holter monitor is a continuous recording of your heart rhythm for 24 hours while you go about your usual daily activities. It is useful in diagnosing arrhythmias (abnormal heart rhythms).

During an arrhythmia, the heart will either beat too fast, too slow, or irregularly. Doctors may order a holter monitor:

To detect arrhythmias that may not occur during a standard EKG

Assess recurrent symptoms such as dizziness, palpitations, or fainting spells

Evaluate the efficacy of anti-arrhythmic medications and pacemakers

To help determine whether areas of the heart do not receive enough blood supply.

How do I prepare for the procedure?

There is no special preparation for holter monitoring. You may eat and go about your normal activities, unless you are told otherwise. Make sure you wear a two-piece outfit to make it easier to hook up the holter monitor.

A technician or a nurse will set you up with the holter monitor. Areas on your chest and shoulders will be cleansed to ensure good electrode contact. Men may need to have areas on their chest shaved. Five electrodes (stick patches) are attached to your skin. Wires attach the electrodes to the monitor. The monitor is small and portable, and can be worn on a strap over the shoulder or around the waist.

You will wear the holter monitor for 24 hours. Occasionally, the doctor will order the holter monitor for 48 hours. The holter monitor is worn all day and night during the 24 hour recording period. You can do anything you would normally do, except take a bath/shower or swim. If the electrodes get wet, they will come off.

The holter monitor records and stores the EKG on a disc during the 24 hours. You will keep a diary during the period you carry the monitor. The diary is very important. It enables technicians/nurses and doctors to correlate your activities and symptoms with the EKG recordings. The information you will write in the diary includes the following:

  • Your activities (walking, climbing stairs, driving, working, etc.)
  • Symptoms you experience (palpitations, chest pain, shortness of breath, etc)
  • The exact time at which the symptoms occurred
At the end of the recording period, you will be instructed on how to remove the holter monitor yourself. The holter monitor and diary can be returned to the front desk the same day the monitor is removed. The disc is scanned by a technician or nurse and analyzed by a computer. A report is printed and reviewed by one of our Cardiologists. A report will also be sent to your primary doctor.

Wear a two piece outfit, preferably a shirt with buttons on the front

Try to sleep on your back with the recorder positioned at your side so that the electrodes are not pulled off..

Do not get the electrodes, wires or monitor wet.

If you have a hairy chest, the areas where the electrodes are placed will need to be shaved.

Avoid electric blankets, magnets, metal detectors, and high voltage areas such as power lines. Signals from such devices may affect recording.

It is important that you keep the electrodes and wires attached for the entire recording. If an electrode comes off, stick it back on your skin. If you have questions, please call our office.

The Holter monitor is hooked up in one of the examination rooms in our office.

The holter monitor placement takes about 10 to 20 minutes to complete.