A Holter monitor is a machine that continuously records the heart's rhythms. The monitor is usually worn for 24 - 48 hours during normal activity.
Electrodes (small conducting patches) are stuck onto your chest and attached to a small recording monitor. You carry the Holter monitor in a pocket or small pouch worn around your neck or waist. The monitor is battery operated.
While you wear the monitor, it records your heart's electrical activity.
It is very important that you accurately record your symptoms and activities so the doctor can match them with your Holter monitor findings.
Electrodes must be firmly attached to the chest so the machine gets an accurate recording of the heart's activity.
While wearing the device, avoid:
Continue your normal activities while wearing the monitor. You may be asked to exercise while being monitored if your symptoms have occurred in the past while you were exercising.
There is no special preparation for the test. Your doctor will start the monitor. You'll be told how to replace the electrodes should they fall off or become loose.
Tell your doctor if you are allergic to any tape or other adhesives. Make sure you shower or bathe before you start the test. You will not be able to do so while you are wearing a Holter monitor.
This is a painless test. However, some people may need to have their chest shaved so the electrodes can stick.
You must keep the monitor close to your body. This may make it hard for you to sleep.
Holter monitoring is used to determine how the heart responds to normal activity. The monitor may also be used:
It may be used to diagnose:
Normal variations in heart rate occur with activities. A normal result is no significant changes in heart rhythms or pattern.
Abnormal results may include various arrhythmias. Changes may mean that the heart is not getting enough oxygen.
The monitor may also detect conduction block, a condition in which the atrial electrical activity is either delayed or does not continue into the ventricles of the heart.
There are no risks associated with the test. However, you should be sure not to let the monitor get wet.
Ambulatory electrocardiography; Electrocardiography - ambulatory
Miller JM, Zipes DP. Diagnosis of cardiac arrhythmias. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 36.
Olgin JE. Approach to the patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 62.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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