24 Hour Holter Monitoring

About the Procedure

Twenty-four Hour Holter Monitoring is a method for a physician, usually a cardiologist, to collect information about the functioning of the heart over a 24-hour time period. Symptoms such as dizziness, angina, fainting, and palpitations, among others, can be indicative of heart arrhythmias undetectable in a short test like an electrocardiogram (ECG). By recording the heart's electrical activity over a longer period of time the physician is able to interpret the causes of the patient's symptoms, abnormal heart behaviors, or potential disease. Monitors record digitally and new software allows for quick interpretation and for using data in new ways. Research into remote access of data and voice contact, expanded software capabilities, and more comfortable chest attachments, is continuous.

The procedure is performed by a physician or technician in a doctor's office or clinic. Wired pads (from three to eight) are attached to the chest with a medical adhesive and gel to improve electrical conductivity. The wires are connected to a small box (the monitor) and the device may be slipped onto a belt or worn around the neck like a long necklace or a shoulder bag. Specific instructions are given on the operation of the monitor, contacting the doctor, and handling situations which may occur, e.g., replacing the pads if they separate from the chest.

What to Know Before the Procedure

A Holter monitor is non-invasive although the patient may find the wires annoying and carrying the box inconvenient. Sleeping with wires and a box is uncomfortable for many patients. Patients may not shower or swim until the device is unattached and being near electrical appliances and magnets may interfere with its operation. There is no danger of electrical shock because the box is battery operated. Normal activities are encouraged so the data reflects heart functions as they occur naturally in the patient's daily life. Any untoward risks are undocumented.

To prepare for wearing a Holter monitor the patient should bathe/shower since they will not be permitted to bathe, shower or swim until the device is removed. The physician will advise if additional preparations are required. Keeping a diary of activities and/or symptoms may be part of the procedure.

What to Know After the Procedure

The device will be removed at the location where it was applied and the patient may resume all normal activities. Once the data is analyzed by a computer program, the physician interprets the results which requires a few days.

If you Need to Travel Outside of your Local Hospital

Patients are told to go about their normal activities so the accumulated data is representative of the patient's routines. Consideration must be given to the locale of the 24-hour period in order to comply with those instructions. The simplicity and brief time span of the procedure is an influential factor in having it performed domestically. However, a discussion with the physician about the possibility of returning the monitor by mail and receiving the results by mail or e-mail may make travel just as simple.