Holter Monitor

Definition

Holter monitor is a form of ambulatory monitoring. It records all heart electrical activity (rhythms) between 24 and 48 hours. There are 3 wires (leads and electrodes) that attach from your chest to a battery powered device usually carried in your pocket, or worn on a belt. You do not have to signal the device to record, as it does it for you for the entire 24-hour 48-hour period.

Why Performed

When a patient has frequent symptoms that may be related to alterations in the electrical conductivity of the heart, a Holter monitor may prove useful. One of the most common symptoms to obtain a Holter monitor is palpitations. Normally your palpitations have to be quite frequent since the monitoring is only for 24 or 48 hour period. If you do not normally have symptoms within the short period of time then a Holter monitor is probably not the right test for you.

Other common symptoms in which a Holter monitor may prove useful, may be:

  • dizziness
  • passing out (syncope)
  • fatigue
  • atrial fibrillation
  • atrial flutter
  • chest pain
  • shortness of breath

This is not an all-inclusive list, but are the most common reasons for obtaining a Holter monitor.

Risks

There are not many risks associated with the Holter monitor. They are similar to obtaining an electrocardiogram. Mostly, the only risk is usually related to reactions to the adhesive tape of the electrodes (adhesive tape-like component that is placed on skin).

Preparation

Not much preparation is required to have a Holter monitor performed. Be prepared to have clean skin before applying the electrodes (adhesive tape-like component that is placed on skin) to your chest wall. You might have to shave your chest at specific locations where the electrodes are placed in order to assure contact with the skin. Sometimes electrodes fall off, but this is not a problem since most devices arrived with multiple sets of adhesive electrodes. You should be ready to where your Holter monitor as long as you may tolerate it and only take it off to shower.

Expectation

For a Holter monitor, you should expect the device to either be attached to you in the cardiologist’s office or sent to you by mail. If it is sent to you by mail, there will be instructions on how to place the electrodes (adhesive tape-like component that is placed on skin) and where to connect the leads. If you have questions please call your cardiologist’s office. The duration of the Holter monitor will most likely be 24 hours, but it may be extended to 48 hours depending on your Doctor’s order. When you have completed your monitoring you will either pack up the Holter monitor and send it via mail, or take it to your cardiologist’s office. You should receive results in approximately 2 to 3 days after the device has been received and the data downloaded. It is important to remember the symptoms in question while wearing the Holter monitor, to determine if your symptoms correlate with any abnormalities found on the Holter monitor recordings. This helps your Doctor determine if any abnormalities found on your Holter monitor are causing the symptoms your are feeling.

Results

Results are usually ready two to three days after the device has been received and data analyzed. In it you will find your basic heart rhythm with any alterations, extra beats, irregular rhythms, highest and lowest heart rates, length of time spent in each irregular rhythm, and any other abnormalities associated with your heart rhythm. Your results will discover relatively benign rhythms such as atrial fibrillation, atrial flutter, supraventricular tachycardia or malignant rhythms such as ventricular tachycardia. Commonly there are extra beats discovered such as premature ventricular contractions (PVC) or premature atrial contractions (PAC).