Holter Monitor

What is a Holter monitor?

A Holter monitor is a wearable device and a type of ambulatory electrocardiogram. It’s a type of heart monitor. It records your heart’s rhythm and rate while you wear it for 24 to 48 hours without breaks. This gives your healthcare provider a long look at your heart’s electrical activity as you go about your day.

This monitor is small (about the size of a deck of playing cards), lightweight and runs on battery power. It has wires and electrodes (small patches) that stick to your skin. You wear a Holter monitor under your clothes while you continue with your regular daily activities.

A Holter monitor doesn’t give real-time information to your provider. If you’re concerned about your symptoms, seek emergency care.

The Holter monitor gets its name from Dr. Norman J. Holter, who created it in the 1950s.

How does a Holter monitor work?

Like an electrocardiogram (EKG), a Holter monitor gathers information about your heart’s electrical activity. Instead of wearing it for a few minutes like an EKG, you wear a Holter monitor for a full day or two. This allows for more chances to pick up unusual activity.

A Holter monitor can help if an EKG doesn’t provide clear results. It can:

• Help find the cause of arrhythmias, heart palpitations and unexplained dizziness
• Check how well heart medications are working

A Holter monitor consists of the following:

• Electrodes: These are stickers on your chest that sense your heart’s electrical activity.
• Wires: The electrodes send the information through wires.
• Holter monitor: This is a battery-powered device that you wear in your pocket or elsewhere on your body. The wires connect to it. The monitor records your heart’s data.

Providers don’t check your device as it records information. They access the collected data after you turn it in.

What to expect while using a Holter monitor

You don’t need to do anything special to prepare for a Holter monitor. You’ll probably want to shower or bathe before putting on the device. You won’t be able to get the monitor wet when you’re wearing it.

A healthcare provider will get you set up, and then you can go about your normal day. They’ll:

• Attach the electrodes to your chest: You’ll need to wear at least two electrodes. A provider may need to shave your chest to make sure the electrodes stay on.
• Help you put on the monitor: They’ll connect it to the electrodes with wires and explain how to take care of the monitor.
• Find a place for the monitor: You can carry the heart monitor in a pocket or bag. You can wear it on a strap around your neck, waist or shoulder.
• Explain how to keep track of your activities and symptoms: You should write down symptoms like shortness of breath, skipped or uneven heartbeats and chest pain. Note when the symptoms happened and what you were doing. For example, maybe you had chest pain while carrying laundry upstairs at 10:30 a.m. Your provider will look at what was going on in your EKG at that time.

Restrictions while wearing a Holter monitor

While wearing your Holter monitor, you should avoid getting it wet. Don’t bathe, shower or swim. Water can damage the device.

You should also avoid things that can keep the sensors from communicating with the monitor, like:

• Having an X-ray
• Going near high-voltage areas, magnets or metal detectors
• Using other electric devices (like microwaves or electric toothbrushes, razors or blankets)

What to expect after using a Holter monitor

After the 24- or 48-hour period, you return the monitor to your healthcare provider. They’ll remove the electrodes at this time. A provider processes your records, including the EKG and your notes. They send a report to your cardiologist (heart specialist).

What are the risks or side effects of a Holter monitor?

Wearing a Holter monitor doesn’t involve any risks or pain. You might have itchiness or irritation from the tape that attaches the electrodes to your chest.

Let your provider know if you have any allergies to tapes or adhesives.

What type of results do you get and what do the results mean?

The results may show that the Holter monitor detected a heart rhythm disorder (arrhythmia), like:

• Atrial fibrillation
• Bradycardia (slow heart rate)
• Tachycardia (fast heart rate)
• Premature ventricular contractions (PVCs)

When should I know the results of the test?

Your provider will contact you with the results within a week or two after the test.

If the results are abnormal, what are the next steps?

Your provider will discuss the next steps with you. They may recommend:

• More cardiac tests
• Heart medications
• A pacemaker
• Cardioversion procedure to help your heart return to a steady rhythm
• Ablation, a treatment for abnormal rhythm that uses hot or cold energy to create scar tissue

When should I call my provider?

Contact your provider if:

• You’re having trouble with the Holter monitor you’re using
• You have a question about how to use the monitor
• An electrode comes loose
• You’re having heart-related symptoms that make you feel uneasy or concerned

Please note that a medical professional isn’t continuously monitoring the findings of this test. You should seek medical care if you develop symptoms.

Can it detect anxiety?

A Holter monitor can’t diagnose anxiety. But if anxiety is causing you to have heart palpitations, the monitor will record them. Your provider will need to analyze the recording to see the kind of palpitations you had. It’s helpful to write down what you’re doing and feeling when you have symptoms.

What’s the difference between an EKG and a Holter monitor?

An EKG measures your heart’s activity at that moment in time, as you’re having the test. But your heart’s rhythm and symptoms can change throughout the day.

Your provider may want to see how your heart’s rhythm changes during the day as you do your regular activities. The Holter monitor gives your provider a more complete picture of your heart rhythm.

What’s the difference between Holter and event monitoring?

A Holter monitor records your heart rhythm continuously for 24 or 48 hours. An event monitor isn’t continuous. It only records your heart’s activity when you feel symptoms and activate the monitor.