Holter Monitoring

A holter monitor is a device that records your ECG over a period of 24 – 48 hours, or occasionally longer. Your ECG shows the electrical activation of your heart and can show whether your heart rhythm is normal (this is called “sinus rhythm”) or whether you are having periods of abnormal fast or slow heart rhythms.

It consists of electrodes (the sticky dots that go onto your chest like a regular ECG), wires and a small machine that attaches to your waistband or hangs around your neck – this bit records the ECG onto a small hard drive. The picture above gives you an idea of what it looks like.

No you don’t. You go into the clinic to have it fitted and again to have it taken off at the end of the monitoring period. For the period of the monitoring you go home or go to work or to school as you would normally.

You should try to have as normal a day as possible, so that the monitor gives the team representative information about your heart rhythm during your normal activities.

The standard ECG that you have in the clinic gives useful information, but only records a short snap-shot of your heart rhythm lasting a few seconds. It doesn’t show what is happening with your ECG during the rest of the day.

Intermittent slow or fast heart rhythms that only last for a short time are unlikely to be picked up on the clinic ECG, but may be picked up on a holter monitor.

You might need to have a holter if you are having palpitations (a sensation of a rapid or irregular heart beat) or if you are having major dizzy spells or black-outs.

Sometimes your medical team may request a routine holter even if you are not having any symptoms. This is because you have a type of heart condition that is known to put you at higher risk of having abnormal heart rhythms.

Not really, other than being a bit of a nuisance. Some people can have a minor reaction to the ECG sticky dots. If this has been a problem for you with previous ECGs or holters, tell the cardiac physiology team when you have it fitted – they may be able to use different ECG dots that are less likely to cause reactions.

The other thing that is helpful is to fill in a diary of what you do over the period of the monitoring, and also write down if you get any symptoms, eg. fast heart rhythms or dizzy spells. This means that the recording can be checked to see if there are any abnormal heart rhythms that coincide with your symptoms.

When you have the monitor fitted you will be given a diary page to fill in with these details.