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Holter Monitoring

What is a Holter Monitor?

A Holter Monitor is a 24 48 hour continuous recording of the heart's electrical activity, more commonly shown on a simple electrocardiogram (ECG). It is a portable recording device that provides important information about the heart and its rhythm throughout the day. This test is entirely painless and is taken during normal activities. It is a valuable tool to determine the mechanism of heart rhythm disturbance (arrhythmia), which would not necessarily be detected by a standard ECG. It can be used for  infants, children or adults.

How does the Holter Monitor work?

The Holter Monitor is fitted with a belt that you wear around your waist. It is battery-powered and has five wires called leads. The leads are attached to flat adhesive disks  called electrodes, which are worn on your chest. When applied, electrical impulses from every heart beat are transmitted to an amplifier which records and saves them on  a solid state memory card for subsequent review and analysis on a specialised scanner and computer.

Reasons for the procedure

The main aim of Holter monitoring is to document and identify occurrences of abnormal electrical behaviour in the heart. These can be random, spontaneous, or related to sleep, emotion or exercise. These events are often infrequent, but sometimes can be life-threatening. Some reasons for your physician to request a Holter Monitor may include:

to evaluate chest pain not reproduced with exercise testing;
to evaluate other signs and symptoms that may be heart-related, such as fatigue, dizziness, or fainting;
to identify irregular heartbeats or palpitations;
to assess risk for future heart-related events in conditions such as cardiomyopathy or Wolff-Parkinson-White syndrome;
to assess the function of an implanted pacemaker;
to determine the effectiveness of therapy for complex arrhythmias;
to help exclude a cardiac cause for your symptoms.

Putting the Holter Monitor on

1. Your physician/technician will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the test.
2. Electrodes will be attached to your chest and the Holter Monitor will be attached to the electrodes with the five leads. The monitor may be clipped onto a belt and worn around your waist.
3. Once you have been hooked up to the monitor and given instructions, you can return to your usual activities, unless your physician instructs you differently. This will allow your physician to identify problems that may only occur with certain activities.
4. You will be instructed to keep a diary of your activities during the recording period. You should write down the date and time of your activities, particularly if any symptoms, such as dizziness, palpitations, chest pain, or other previouslyexperienced symptoms occur.

Taking the Holter Monitor off

Simply remove and discard the five adhesive electrode patches off your chest. You must return the entire device, along with the diary, to the Cardiac Department on level  three, between 8:30am and 5:00pm, Monday to Friday. After hours, it can be returned to Edgar Stephens Ward on level three, or it may be returned in a prepaid courier bag which can be purchased from reception.

Are there any risks involved?

The Holter Monitor is a non-invasive method of assessing the heart's function. Risks associated with the Holter Monitor are rare. Prolonged application of the adhesive  electrode patches may cause skin irritation or tissue breakdown at the application site.

Holter Monitor Analysis and Interpretation 

Three channels of recorded electrocardiograms (ECG) are analysed by sophisticated arrhythmia detection software to find and label abnormalities. The ECG is run through a computer, which analyses the rate and rhythm of the heart, looks for changes in the heart's electrical activity, and produces a record of every heartbeat during the 24 or 48 hours. Symptoms recorded in the diary can then be correlated with changes in the ECG.

Frequently asked questions

How do I pay for the Holter Monitoring test?
For Medicare card holders the Hospital will bulk bill (please remember to bring your Medicare card).

How long will the test take?
The Holter Monitor records for 24 hours or 48 hours. Your physician will determine the best option for you.

Can I have a shower or swim during the test?
No. Water will cause damage to the Holter Monitor.

Do I have to do anything during the Holter monitoring?
Yes. Remember to keep a diary of your activities during the recording period. Your physician/technician will give the diary to you.

When will I receive the Holter Monitor results?
Results of the test and report will be forwarded to your referring doctor.

Precautions

Please take care of the monitor.

• Do not drop the monitor
• Do not get the monitor wet

The cost of any damage caused to the monitor will have to be reimbursed in full.

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