When preparing a patient for Holter monitoring

Keep the monitor inside its pouch. (Do not bathe or shower during the 24 hour period or monitor will be irreparably damaged).
The monitor records throughout the entire 24 hours. Please do not interfere with the appliance.
Do not remove the electrodes.
Promptly re-attach any electrodes if any fall off.

On the day of the test

Please shower prior to your appointment. (Do not use powder or body lotions on your chest). Wear clothes that are easy to remove from the waist up. Allow approximately 30 minutes for the monitor to be fitted.
It is advisable for women to wear a bra. We suggest that both men and women wear a firm fitting singlet or T-shirt to bed at night to reduce the chance of leads becoming unattached.
The area where the seven electrodes are fitted to the chest (similar to an ECG test) may need to be shaved and rubbed with alcohol pads to remove natural oils from the skin. This will ensure that contact is adequate when attaching the electrodes and leads. The leads may be secured with extra tape. The recorder is attached with a belt around your waist.
You will be instructed to record your daily events in the diary provided. Please ensure you note sleep times and wake-up times and any other events you feel might be relevant (instructions are inside the front cover of the diary).
When a symptom occurs, press the event button. Be precise when noting the time a symptom occurred. The diary of events is an important part of the test and should be returned with the monitor - even if there is nothing written in it.
We also require a list of your current medications and when you take them. This can be recorded in the diary or on a separate page attached to it.

Índice Show

On the day of the test
Why might I need a Holter monitor?
What are the risks of a Holter monitor?
How do I get ready for a Holter monitor?
What happens during a Holter monitor?
What happens after a Holter monitor?

If you have any problems, please contact the Australian Clinical Labs Collection Centre where the monitor was fitted or please call our Customer Service Centre.

Download Instructions

What is a Holter monitor?

A Holter monitor is a small, battery-powered medical device that measures your heart’s activity, such as rate and rhythm. Your doctor may ask you to use one if they need more information about how your heart functions than a routine electrocardiogram (EKG) can give them.

Twenty-four hour Holter monitoring is a continuous test to record your heart’s rate and rhythm for 24 hours. You wear the Holter monitor for 12 to 48 hours as you go about your normal daily routine. This device has electrodes and electrical leads exactly like a regular EKG, but it has fewer leads. It can pick up not only your heart’s rate and rhythm but also when you feel chest pains or exhibit symptoms of an irregular heartbeat, or arrhythmia.

Holter monitor testing is also sometimes called ambulatory electrocardiography. There are other types of devices that can be used to measure heart activity for longer periods of time.

An EKG is a medical test that’s used to measure your heart rate and rhythm. It’s also used to look for other abnormalities that may affect normal heart function. During an EKG, electrodes are placed on your chest to check your heart’s rhythm. You may experience heart rhythm irregularities that don’t show up at the time the EKG is done because you’re only hooked up to the machine for a very brief amount of time.

Abnormal heart rhythms and other types of cardiac symptoms can come and go. Monitoring for a longer period of time is necessary to record these events. The Holter monitor lets your doctor see how your heart functions on a long-term basis. The recordings made by the monitor help your doctor determine if your heart is getting enough oxygen or if the electrical impulses in the heart are delayed or early. These irregular impulses may be referred to as arrhythmias or abnormal heart rhythms.

If you’re already being treated for heart problems, wearing your monitor can help your doctor determine if your medicine is working or if changes need to be made. It can also help them to see why you might be experiencing other symptoms of irregular heartbeat, such as dizziness, faintness, or feeling like your heart is racing or skipping a beat.

The Holter monitor is small. It’s slightly larger than a deck of playing cards. Several leads, or wires, are attached to the monitor. The leads connect to electrodes that are placed on the skin of your chest with a glue-like gel. The metal electrodes conduct your heart’s activity through the wires and into the Holter monitor, where it’s recorded.

You wear a small pouch around your neck that holds the monitor itself. It’s important to keep the monitor close to your body during the testing period to make sure the readings are accurate. Your doctor will show you how to reattach electrodes if they become loose or fall off during the testing period.

You’ll get instructions that explain how to take care of your monitor and what not to do while you’re wearing it. It’s important to avoid bathing, showering, and swimming while you’re wearing the monitor.

You’re encouraged to participate in your normal activities during the 24-hour Holter test. You’ll be directed to record your activities in a notebook. This helps your doctor determine if changes in heart activity are related to your behaviors and movements.

Wearing the Holter monitor itself has no risks involved. However, the tape or adhesives that attach the electrodes to your skin can cause mild skin irritation in some people. Make sure to tell the technician that attaches your monitor if you’re allergic to any tapes or adhesives.

A 24-hour Holter monitor test is painless. However, be sure to record any chest pain, rapid heartbeat, or other cardiac symptoms you have during the testing period.

Keep the Holter monitor dry to ensure it functions properly. Take a bath or shower before your appointment to have the monitor fitted and don’t apply any lotions or creams. Avoid activities that might lead to the monitor getting wet.

Magnetic and electrical fields may interfere with the function of the Holter monitor. Avoid areas of high voltage while wearing the monitor.

In an event where misreadings or false-positives do occur, the Holter may need to be applied again.

After the recommended testing time frame has passed, you’ll return to your doctor’s office to have the Holter monitor removed. Your doctor will read your activity journal and analyze the results of the monitor. Depending on the results of the test, you may need to undergo further testing before a diagnosis is made.

The Holter monitor may reveal that your medicine isn’t working or your dosage needs to be altered if you’re already taking medication for an abnormal heart rhythm. It’s especially useful in detecting abnormal heart rhythms that are painless and unknown to you.

Wearing a Holter monitor is painless and one of the best ways to identify potential heart problems or other issues.

The Holter monitor is a type of portable electrocardiogram (ECG). It records the electrical activity of the heart continuously over 24 hours or longer while you are away from the doctor's office. A standard or "resting" ECG is one of the simplest and fastest tests used to evaluate the heart. Electrodes (small, plastic patches that stick to the skin) are placed at certain points on the chest and abdomen. The electrodes are connected to an ECG machine by wires. Then, the electrical activity of the heart can be measured, recorded, and printed. No electricity is sent into the body.

Natural electrical impulses coordinate contractions of the different parts of the heart. This keeps blood flowing the way it should. An ECG records these impulses to show how fast the heart is beating, the rhythm of the heart beats (steady or irregular), and the strength and timing of the electrical impulses. Changes in an ECG can be a sign of many heart-related conditions.

Your healthcare provider may request a Holter monitor ECG if you have symptoms, such as dizziness, fainting, low blood pressure, ongoing fatigue (tiredness), and palpitations and a resting ECG doesn’t show a clear cause. You wear the same kind of ECG electrode patches on your chest, and the electrodes are connected by wires to a small, portable recording device.

Certain arrhythmias (abnormal heart rhythms) may occur only now and then. Or, they may occur only under certain conditions, such as stress or activity. Arrhythmias of this type are hard to record on an ECG done in the office. Because of this, the healthcare provider might request a Holter monitor to get a better chance of capturing any abnormal heartbeats or rhythms that may be causing the symptoms. Some Holter monitors also have an event monitor feature that you activate when you notice symptoms.

You will get instructions on how long you will need to wear the monitor (usually 24 to 48 hours), how to keep a diary of your activities and symptoms during the test, and personal care and activity instructions, which include keeping the device dry while you are wearing it.

Why might I need a Holter monitor?

Some reasons for your healthcare provider to request a Holter monitor recording or event monitor recording include:

To evaluate chest pain that can't be reproduced with exercise testing
To evaluate other signs and symptoms that may be heart-related, such as tiredness, shortness of breath, dizziness, or fainting
To identify irregular heartbeats or palpitations
To assess risk for future heart-related events in certain conditions, such as hypertrophic cardiomyopathy (thickened heart walls), after a heart attack that caused weakness of the left side of the heart, or Wolff-Parkinson-White syndrome (where an abnormal electrical conduction pathway exists within the heart)
To see how well a pacemaker is working
To determine how well treatment for complex arrhythmias is working

There may be other reasons for your healthcare provider to recommend the use of a Holter monitor.

What are the risks of a Holter monitor?

The Holter monitor is an easy way to assess the heart’s function. Risks associated with the Holter monitor are rare.

It can be hard to keep the electrodes stuck to your skin, and extra tape may be needed. It may be uncomfortable when the sticky electrodes and tape are taken off. If the electrodes are on for a long time, they may cause tissue breakdown or skin irritation at the application site.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before wearing the monitor.

Certain factors or conditions may interfere with or affect the results of the Holter monitor reading. These include, but are not limited to:

Close proximity to magnets, metal detectors, high-voltage electrical wires, and electrical appliances such as shavers, toothbrushes, and microwave ovens. Cell phones and MP3 players can also interfere with the signals and should be kept at least 6 inches away from the monitor box.
Smoking or using other forms of tobacco
Certain medicines
Excessive sweating, which may cause the leads to loosen or come off

How do I get ready for a Holter monitor?

Your healthcare provider will explain the procedure to you and you can ask questions.
You do not need to fast (not eat or drink).
Based on your medical condition, your healthcare provider may request other specific preparation.

What happens during a Holter monitor?

A Holter monitor recording is generally done on an outpatient basis. Procedures may vary depending on your condition and your healthcare providers practice.

Generally, a Holter monitor recording follows this process:

You will be asked to remove any jewelry or other objects that may interfere with the reading.
You will be asked to remove your clothing from the waist up so that electrodes can be attached to your chest. The technician will ensure your privacy by covering you with a sheet or gown and exposing only the necessary skin.
The areas where the electrodes patches are placed are cleaned, and in some cases, hair may be shaved or clipped so that the electrodes will stick closely to the skin.
Electrodes will be attached to your chest and abdomen. The Holter monitor will be connected to the electrodes with wires. The small monitor box may be worn over your shoulder like a shoulder bag, around your waist, or it may clip to a belt or pocket.
Find out if you will have to change the batteries in the monitor. Be sure you know how to do it and have extra batteries on hand.
Once you have been hooked up to the monitor and given instructions, you can return to your usual activities, such as work, household chores, and exercise, unless your healthcare provider tells you otherwise. This will allow your healthcare provider to identify problems that may only occur with certain activities.
You will be instructed to keep a diary of your activities while wearing the monitor. Write down the date and time of your activities, particularly if any symptoms, such as dizziness, palpitations, chest pain, or other previously experienced symptoms, occur.

What happens after a Holter monitor?

You should be able to go back your normal diet and activities, unless your healthcare provider instructs you differently.

Generally, there is no special care after a Holter monitor recording.

Tell your healthcare provider if you develop any signs or symptoms you had before the recording (for example, chest pain, shortness of breath, dizziness, or fainting).

Your healthcare provider may give you other instructions after the procedure, depending on your particular situation.