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Holter EKG - Non-Stop Heart Monitoring 24/7

Apr 16

Discover everything about 24/7 Holter EKG monitoring, when it's needed, and how this test can help in diagnosing heart conditions. 

What is Holter EKG?

A Holter EKG, also called ambulatory electrocardiogram, is a portable device that monitors your heart's electrical activity for 24 to 48 hours, sometimes even up to 7 days. 

Unlike a standard EKG which takes a quick snapshot of your heart rhythm, a Holter monitor captures your heart activity as you go about your daily routine. 

This helps doctors identify heart rhythm problems that may come and go.


When do I need a Holter Monitor?

You might need a Holter monitor if you have any of the following:

  • Unexplained fainting or dizziness.
  • Chest pain.
  • Palpitations (feeling like your heart is racing or fluttering).
  • Shortness of breath.
  • Unexplained fatigue.
  • Inconclusive results from a standard electrocardiogram (ECG).

A standard ECG only measures your heart rhythm for a short period of time. A Holter monitor can help your doctor identify heart rhythm problems that don't happen very often.

Here are some additional reasons why your doctor might order a Holter monitor:

  • To see how well a pacemaker is working.
  • To see how well your heart is responding to treatment for an arrhythmia.
  • To assess your risk for future heart problems if you have a condition that can affect your heart rhythm, such as high blood pressure or diabetes.


Types of Holter EKG

At the Biomed Scan clinic, you can benefit from several types of Holter, differentiated by the monitoring period.


There are two main Holter monitors:

  • Standard (24-48 hours): Most common, for typical heart rhythm issues.
  • Extended (up to 7 days): For infrequent problems or longer monitoring needs.

Other options include:

  • Wireless: More freedom of movement during wear.
  • Event recorder: Worn short-term to capture specific symptoms.
  • Implantable loop recorder (ILR): Long-term monitoring device implanted under the skin.


Risks associated with Holter ECG

A Holter monitor is a safe and non-invasive test. There are very few risks associated with it. 

The main risk is skin irritation from the adhesive electrodes that attach the monitor to your chest. This irritation is usually mild and goes away on its own once the monitor is removed.

Here are some things that can increase your risk of skin irritation:

  • Sensitive skin.
  • Allergies to adhesives.
  • Excessive sweating.

In very rare cases, there may be some interference with the Holter monitor's recordings from certain medical devices, such as pacemakers or defibrillators. If you have any implanted medical devices, be sure to tell your doctor before having a Holter monitor test.

Overall, the benefits of a Holter monitor far outweigh the risks. If you have any concerns about the test, be sure to talk to your doctor.


Patient preparation

For an accurate Holter monitor test:

  1. Wear loose clothes for easy placement and comfort.
  2. Skip lotions and creams on your chest – they can interfere with electrode adhesion.
  3. Men with chest hair may need some removal for better electrode contact.
  4. Shower beforehand for clean, dry skin.
  5. Avoid strenuous exercise and stress before the test – they can alter heart rhythm readings.


How is the procedure conducted?

A Holter monitor test is a fairly simple and painless procedure. Here's a breakdown of what to expect:

Attaching the electrodes:

  • A technician will place several sticky electrodes, similar in size to a dime, on specific spots on your chest. In some cases, they might need to shave a small area of chest hair to ensure good contact.
  • A conductive gel will likely be applied to each electrode to improve signal transmission.

Wearing the monitor:

  • The electrodes will be connected by wires to a small, portable device (the Holter monitor) which is typically worn on a belt or strap around your waist or shoulder. Newer models might be patchable directly onto your chest.
  • You'll be instructed on how to wear and care for the monitor during the testing period.

Activity log:

  • You'll likely be given a diary or logbook to record your activities and any symptoms you experience throughout the day, such as chest pain, dizziness, or heart palpitations. Noting down the timings of these events can help your doctor correlate them with the heart rhythm recordings.

Returning the monitor:

  • After the designated wearing period (usually 24 to 48 hours), you'll return to the healthcare facility to have the monitor removed.
  • The technician will collect the device and the activity log for analysis by a doctor.

During the wearing period, you'll be encouraged to go about your normal daily activities as much as possible. This helps doctors assess your heart rhythm under various conditions. However, you might be advised to avoid strenuous exercise or activities that could damage the monitor or get it wet.


Expectations after ECG Holter monitoring

Once your Holter monitor test is done, the doctor will review the recordings and talk to you about what they found. What happens next depends on the results, here are some possibilities:


Normal results: 

A normal Holter monitor result doesn't necessarily rule out all heart problems, but it's a positive finding. Your doctor will discuss these results with you and may suggest continuing to monitor your symptoms and any current treatment plan.

Abnormal results: 

If the results indicate certain abnormalities, such as arrhythmias, ectopic beats, tachycardia, bradycardia, or other cardiac problems, your cardiologist will consider the following options:


  1. a) Further investigation: Blood tests, cardiac ultrasound, angiography, or stress tests, to determine the exact cause of the cardiac problem.


  1. b) Pharmacological treatment: The doctor may prescribe medications to manage arrhythmias or other identified cardiac problems: beta-blockers, calcium channel blockers, antiarrhythmics, or anticoagulants.


  1. c) Non-pharmacological therapy: If medications are not effective or if the patient has a high risk of complications - radiofrequency ablation, implantation of a cardiac device (e.g., a pacemaker or an implantable cardioverter defibrillator), surgical interventions on the heart.



Wearing time for an ECG Holter monitor depends on both the device and your specific situation. Doctors typically recommend 24 to 48 hours, but it can go up to 7 days depending on your symptoms and their advice.


Results and Detectable Conditions

After the Holter monitor is removed, a cardiologist, a heart specialist, will analyze the recordings. They will look for any unusual patterns in your heart rhythm that might indicate a potential underlying condition. 

These recordings can help detect various issues, including:

  • Arrhythmias (irregular heartbeats).
  • Cardiac ischemia (reduced blood flow to the heart muscle).
  • Electrical conduction disorders (problems with the heart's electrical signals).
  • Side effects of certain medications or treatments (such as medications that can affect heart rhythm).



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