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Holter monitor (24h)
     
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Holter monitor (24h)

Ambulatory electrocardiography; Electrocardiography - ambulatory; Atrial fibrillation - Holter; Flutter - Holter; Tachycardia - Holter; Abnormal heart rhythm - Holter; Arrythmia - Holter; Syncope - Holter; Arrhythmia - Holter

 

A Holter monitor is a machine that continuously records the heart's rhythms. The monitor is worn for 24 to 48 hours during normal activity.

How the Test is Performed

 

Electrodes (small conducting patches) are stuck onto your chest. These are attached by wires to a small recording monitor. You carry the Holter monitor in a pocket or pouch worn around your neck or waist. The monitor runs on batteries.

While you wear the monitor, it records your heart's electrical activity.

  • Keep a diary of what activities you do while wearing the monitor, and how you feel.
  • After 24 to 48 hours, you will return the monitor to your health care provider's office.
  • The provider will look at the records and see if there have been any abnormal heart rhythms.

It is very important that you accurately record your symptoms and activities so the provider 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:

  • Electric blankets
  • High-voltage areas
  • Magnets
  • Metal detectors

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.

 

How to Prepare for the Test

 

You do not need to prepare for the test.

Your provider will start the monitor. You'll be told how to replace the electrodes if they fall off or get loose.

Tell your provider 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.

 

How the Test will Feel

 

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.

Occasionally there may be an uncomfortable skin reaction to the sticky electrodes. You should call the provider's office where it was placed to tell them about it.

 

Why the Test is Performed

 

Holter monitoring is used to determine how the heart responds to normal activity. The monitor may also be used:

  • After a heart attack
  • To diagnose heart rhythm problems that may be causing symptoms such as palpitations or syncope (passing out/fainting)
  • When starting a new heart medicine

Heart rhythms which may be recorded include:

  • Atrial fibrillation or flutter
  • Multifocal atrial tachycardia
  • Paroxysmal supraventricular tachycardia
  • Slow heart rate (bradycardia)
  • Ventricular tachycardia

 

Normal Results

 

Normal variations in heart rate occur with activities. A normal result is no significant changes in heart rhythms or pattern.

 

What Abnormal Results Mean

 

Abnormal results may include various arrhythmias such as those listed above. Some changes may mean that the heart is not getting enough oxygen.

 

Risks

 

Other than the uncommon skin reaction, there are no risks associated with the test. However, you should be sure not to let the monitor get wet.

 

 

Open References

References

Curtis AB, Tomaselli GF. Approach to the patient with cardiac arrhythmias. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 61.

Olgin JE. Approach to the patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 56.

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  • Holter heart monitor

    Holter heart monitor

    illustration

  • Heart - section through the middle

    Heart - section through the middle

    illustration

  • Heart - front view

    Heart - front view

    illustration

  • Normal heart rhythm

    Normal heart rhythm

    illustration

  • Conduction system of the heart

    Conduction system of the heart

    illustration

    • Holter heart monitor

      Holter heart monitor

      illustration

    • Heart - section through the middle

      Heart - section through the middle

      illustration

    • Heart - front view

      Heart - front view

      illustration

    • Normal heart rhythm

      Normal heart rhythm

      illustration

    • Conduction system of the heart

      Conduction system of the heart

      illustration

    Self Care

     

      Tests for Holter monitor (24h)

       
       

      Review Date: 5/8/2022

      Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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