What is a Holter Monitor
and what information does it provide?
Preparing for the test
How is it performed?
How long does it take?
How safe is it?
How quickly will I get the results?
What is Holter
Monitor? A Holter monitor is a continuous
tape recording of a patient's EKG for 24 hours. Since
it can be worn during the patient's regular daily
activities, it helps the physician correlate symptoms
of dizziness, palpitations (a sensation of fast or
irregular heart rhythm) or black outs. Since the recording
covers 24 hours, on a continuous basis, Holter monitoring
is much more likely to detect an abnormal heart rhythm
when compared to the EKG which lasts less than a minute.
It can also help evaluate the patient's EKG
during episodes of chest pain, during which time there
may be telltale changes to suggest ischemia (pronounced
is-keem-ya) or reduced blood supply to the muscle
of the left ventricle.
I prepare for the Test? The only requirement
is that the patient wear loose-fitting clothes. Buttons
down the front of a shirt or blouse is preferable.
This makes it convenient to apply the EKG electrodes,
and also comfortably carry the monitor in a relatively
the Test Performed? The chest is cleansed
with an alcohol solution to ensure good attachment
of the sticky EKG electrodes. Men with hairy chest
may require small areas to be shaved. The EKG electrodes
(circular white patches on the left) are applied to
the chest. Thin wires are then used to connect the
electrodes to a small tape recorder. The tape recorder
is secured to the patient's belt or it can be slung
over the shoulder and neck with the use of a disposable
pouch. The recorder is worn for 24 hours and the patient
is encouraged to continue his or her daily activities.
To avoid getting the setup wet and damaging the recorder,
the patient will not be able to shower for the duration
of the test. A diary or log is provided so that the
patient can record activity (walking the dog, upset
at neighbor, etc.) and symptoms (skipped heartbeats,
chest discomfort, dizziness, etc.) together with the
time. The Holter monitor has an internal clock which
stamp the time on the EKG strips. These can be used
to correlate the heart rhythm with symptoms or complaints.
After 24 hours, the Holter monitor needs to be returned
to the laboratory. This can be removed by the staff.
However, if you live out of town or need to take a
shower before leaving the house, the monitor can be
disconnected from the electrodes and sent back to
the laboratory, together with the completed diary.
the Holter Monitor to the doctor's office, satellite
clinic or hospital lab, the tape is removed from the
recorder and scanned by a technician. Multiple EKG
strips are recorded on paper together with a computer-generated
summary that provides details about the patient's
heart rate and rhythm during the recording. This information
is then provided to your doctor.
How long does it take?
It takes approximately 10 to 15 minutes to apply the
monitor and less than 5 minutes to remove it. The
patient will also receive directions. Many monitors
are also equipped with an "event" button.
Pressing the button during a symptom (dizziness, for
example) will help the technician print an ECG from
that precise time.
How safe is the test?
Holter monitoring is extremely safe and no different
than carrying around a small tape recorder for 24
hours. Some patients are sensitive to the electrode
adhesive, but no serious allergic reactions are known
I get the results? The report is provided
to the physician, together with multiple EKG strips
after the tape has been scanned by the technician.
If the technician sees a rhythm that is life-threatening
or potentially dangerous the physician is informed
immediately. Otherwise, it may take a few days before
you get the official results from your physician's
office. At that time, you may also receive additional
recommendations based upon the results of the test.
For example, a pacemaker may be recommended if a patient
has blackouts and the Holter monitor shows a seriously
slow heart beat during the test.