Holter Monitor

Alternative Names : Ambulatory electrocardiography; Electrocardiography – ambulatory

Definition
A Holter monitor is a machine that continuously records the heart’s rhythms. The monitor is usually worn for 24 – 48 hours during normal activity.It is a portable EKG device that records your heart rhythm over time, outside the hospital or doctor’s office.Whereas a regular EKG examines your heart’s electrical activity for a few minutes, the Holter monitor examines changes over a sustained period of time-usually a 24- to 48-hour period-while you go about your daily activities and even while you sleep. Doctors use it to evaluate symptoms that come and go and that might be related to heart-rhythm changes.

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How the Test is Performed ?
Electrodes (small conducting patches) are stuck onto your chest and attached to a small recording monitor. You carry the Holter monitor in a pocket or small pouch worn around your neck or waist. The monitor is battery operated.

While you wear the monitor, it records your heart’s electrical activity. You should keep a diary of what activities you do while wearing the monitor. After 24 – 48 hours, you return the monitor to your doctor’s office. The doctor will look at the records and see if there have been any irregular heart rhythms.

It is very important that you accurately record your symptoms and activities so that the doctor can match them with your Holter monitor findings.
Why the Test is Performed ?
Holter monitoring is used to determine how the heart responds to normal activity. The monitor may also be used:

*After a heart attack
*To diagnose heart rhythm problems
*When starting a new heart medicine

It may be used to diagnose:
*Atrial fibrillation/flutter
*Multifocal atrial tachycardia
*Palpitations
*Paroxysmal supraventricular tachycardia
*Reasons for fainting
*Slow heart rate (bradycardia)
*Ventricular tachycardia

What happens when the test is performed?
A technician in your doctor’s office or a diagnostic lab fits you with a Holter monitor and explains how to use it. Five stickers are attached to your chest.Wires snap onto each of these stickers and connect them to the monitor. The wires detect your heart’s electrical pattern throughout the day, while the monitor records and stores the data for doctors to interpret later. You can fit the monitor into a purse or jacket pocket or wear it over your shoulder by its strap.

You can go about your normal activities with two exceptions. First, you can’t take a shower or bath during the period that you’re wearing the monitor. Second, you are given a small diary in which to note any worrisome symptoms you feel and record the time when they occur. The doctor will later review both your diary and the data about your heart’s activity from the monitor, to see if any symptoms you experienced were caused by some underlying heart problem. There are no side effects from the testing.
How to Prepare for the Test ?
There is no special preparation for the test. Your doctor will start the monitor. You’ll be told how to replace the electrodes should they fall off or become loose.

Tell your doctor if you are allergic to any tape or other adhesives. Make sure you shower or bathe before you start the test. You will not be able to do so while you are wearing a Holter monitor

Men with a lot of hair on their chest will probably have to shave it.

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How the Test Will Feel?
This is a painless test. However, some people may need to have their chest shaved so the electrodes can stick.

You must keep the monitor close to your body. This may make sleeping difficult for some people.

You should continue your normal activities while wearing the monitor.

Risk Factors:
There are no risks.However, you should be sure not to let the monitor get wet.

Must  you do anything special after the test is over?
You need only return the Holter monitor.

Normal Results:-
Normal variations in heart rate occur with activities. A normal result is no significant changes in heart rhythms or pattern.

What Abnormal Results Mean?
Abnormal results may include various arrhythmias. Changes may mean that the heart is not getting enough oxygen.

The monitor may also detect conduction block, a condition in which the atrial electrical activity is either delayed or does not continue into the ventricles of the heart.

How long is it before the result of the test is known?
It usually takes a few days for your recording to be printed out and examined.

Considerations :-
Electrodes must be firmly attached to the chest so the machine gets an accurate recording of the heart’s activity.

While wearing the device, avoid:
*Electric blankets
*High-voltage areas
*Magnets
*Metal detectors

It is very important for you to keep a diary of symptoms. The diary should include the date, time of day, type, and duration of symptoms.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/holter-monitor.shtml
http://www.nlm.nih.gov/MEDLINEPLUS/ency/imagepages/8810.htm
http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/003877.htm

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