Holter Monitoring

A Holter monitor records the electrical activity of the heart for 24 to 48 hours. Another name for this is ambulatory electrocardiogram, or EKG. Holter monitoring is useful in finding a defective rhythm of the heart and relating this to any symptoms.

Many patients complain of unusual pulsations and irregular or rapid heartbeats. While being examined and tested, however, the patient may not experience these symptoms. An EKG test given by a healthcare provider may not give a true measure of heart activity. A patient's anxiety can alter the results of an EKG test and irregular heartbeats may not occur during the test.

The Holter monitor is one way to analyze the heart rhythm while the person is performing usual daily activities. It can also be used to:

• detect problems missed in a regular EKG

• evaluate chest pain

• check activity after a heart attack

• evaluate a new pacemaker and

• check the effectiveness of medications

Holter monitoring usually lasts for 24 to 48 hours. The person wears a small tape recorder on a belt or shoulder strap. Wires run from the recorder to electrodes attached to the chest. These electrodes must be kept dry. The person goes about his daily activities as he would normally do. Loose fitting clothes need to be worn while wearing the monitor. The only restriction while wearing the monitor is no showering.

During the test, activities, symptoms, and the times the symptoms are experienced are logged by the patient into a diary. Entries to the log should include all activities such as exercise, sleeping, emotional upsets, and taking medications. All symptoms are also included, such as dizziness, chest pain, unusual heartbeats, and fatigue.

When the tape is assessed, the diary information can be linked to what the EKG shows. This helps the healthcare provider better understand the recorded tracings of the monitor.

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