The Cardiovascular Institute - Holter Monitoring

A Holter monitor test is an ambulatory electrocardiogram (EKG) recording. It provides a continuous tape recording of an EKG for 24 hours. In some cases, it may be worn for 48 hours.

A Holter helps detect abnormal heart rhythms, which may last less than a minute and, therefore, may not be spotted on a traditional EKG. It can help evaluate an EKG during episodes of chest pain, palpitations, fainting, or other symptoms. Holter monitoring may help assess the functioning of a pacemaker.

The monitor may be attached to the chest with 5 or 7 electrodes in either a doctor’s office or a hospital. The electrodes are attached to wires that connect to a small tape recorder. The recorder is worn either attached to a belt or to a strap over the shoulder. Normal activities are resumed for the next 24 hours while the monitor records any unusual heart rhythms. During that time, a diary of the activities and symptoms is kept. The diary is returned when the monitor is disconnected. There is no pain or sensation experienced during the test.

Before going for the test, take a shower since the electrodes will need to stay dry for 24 hours. Wearing a shirt or blouse that buttons down the front may make it convenient to wear the monitor discreetly and comfortably.
All clothing above the waist will be removed and excess chest hair on men may be shaved in the small areas where 5- to 7 electrodes will be placed. Each electrode is attached via a wire to a small, portable monitor. The monitor is worn either on a belt or slung with a shoulder strap.
A diary is given to log all activities and symptoms while the monitor is worn. Note symptoms such as pain, headache, dizziness, or shortness of breath. List activities such as sleeping, exercising, eating, defecating, engaging in sexual activity, taking medications, and drinking (and whether it was alcohol or coffee or something else containing caffeine). Also list with a time, any strong emotions, such as crying, anger, laughing, panic, etc. (The monitor has an internal time clock to correlate activities and symptoms with the heart’s activity. Some also have an “event” button that is pressed during symptoms.).
Do not remove the monitor, nor any tape that has been placed over the wires, and do not shake the wires.
If a wire comes unsnapped from its electrode, just snap it back on and note the time in the diary.
Do not open the monitor, and try not to drop it. Either may interfere with the recording.
Do not bathe or swim because moisture will loosen the electrodes.
Do not use any body powder.
Do not use an electric blanket, which might interfere with the recording.
Beyond these precautions, engage in normal activities.
After 24 hours, return to the doctor’s office for removal of the electrodes and monitor.
A report will be provided to the doctor within a few days. However, if anything potentially dangerous is noted, the physician is informed immediately.

You may have small red marks where the electrodes were placed. To avoid skin chafing, don’t scrub them. Wash them gently each day, and they will disappear in a few days.