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Holter Monitoring

Non-Invasive Tests


• Definition of Holter Monitoring

Ambulatory electrocardiography, commonly known as Holter monitoring after its originator, provides a continuous record of the electrical activity of the heart over a 24 or 48-hour period. A holter monitor is a continous tape recording of a patient’s ECG for 24 hours.  

• Description of Holter Monitoring

A Holter monitor is a portable device small enough to be worn by a patient during normal activity. It consists of an electrocardiograph and a recording system capable of storing 24 hours or more of the individual's ECG record. It is particularly useful in obtaining a record of cardiac arrhythmia that would not be discovered by means of an ECG record of only a few minutes duration.
In some cases, a physician may want to know what happens to an individual's heart rate over a longer period of time than can be measured with an electrocardiogram in a single office visit. The Holter monitor provides a means of recording an ECG continuously on a small cassette tape, flash disk or the newer systems that digitally records information usually for 24 hours, while the patient goes through normal daily activities.   

This is a digital ambulatory holter monitor that gives a 24-hour full disclosure of hearts activity. It also has three-channel data recorder and a removable flash disk.  

• Indications for a Holter Monitor

The four heart valves include the following:

  •  Atrial fibrillation/flutter

  •  Multifocal atrial tachycardia

  •  Paroxysmal supraventricular tachycardia

  •  Palpitations

  •  Fainting

  •  When given cardiac medication

  •  After a heart attack


How do I prepare for the Test?

The only requirement is that the patient wear loose-fitting clothes. Buttons down the front of a shirt or blouse is preferable. This makes it convenient to apply the ECG electrodes, and also comfortably carry the monitor in a relatively discreet manner. Shower or bathe before you start the test--you will not be able to do so while you are wearing a holter monitor  

How is the Test Performed?

The chest is cleansed with an alcohol solution to ensure good attachment of the sticky ECG electrodes. Men with hairy chest may require small areas to be shaved. The ECG electrodes (circular white patches on the left) are applied to the chest. Thin wires are then used to connect the electrodes to a small tape recorder. The tape recorder is secured to the patient's belt or it can be slung over the shoulder and neck with the use of a disposable pouch. The recorder is worn for 24 hours and the patient is encouraged to continue his or her daily activities. To avoid getting the setup wet and damaging the recorder, the patient will not be able to shower for the duration of the test. A diary or log is provided so that the patient can record activity (walking the dog, doing some gardening etc.) and symptoms (skipped heartbeats, chest discomfort, dizziness, etc.) together with the time. The Holter monitor has an internal clock which stamp the time on the ECG strips. These can be used to correlate the heart rhythm with symptoms or complaints. The recording is then analyzed, a report of the heart's activity is tabulated, and irregular heart activity is correlated with your activity at the time.
It is very important that you accurately record your symptoms and activities so that the doctor can correlate them with your Holter monitor findings.  

How Safe Is The Test

Holter monitoring is extremely safe and no different than carrying around a small tape recorder for 24 hours. Some patient's are sensitive to the electrode adhesive, but no serious allergic reactions are known.  

What abnormal results mean

Abnormal results may include various arrhythmias. ST segment changes (alterations in the wave form of the electrical conduction pattern of the heart) may indicate that the heart is not receiving enough oxygen and may also correlate with chest pain.

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