Holter Monitoring

About This Screening

What is a Holter monitor?

A Holter monitor is a continuous, 24- or 48-hour EKG recording used to evaluate possible heart rhythm or heart rate abnormalities during your normal day.

Also called an ambulatory electrocardiography (ECG) device or a Holter cardiac monitor, it helps your clinician capture irregularities that a brief, in-office ECG might miss. If you are experiencing skipped beats or fluttering, a Holter monitor for palpitations can be especially helpful.

How does a Holter monitor work?

In short, the Holter monitor test uses small electrodes placed on your chest with sticky pads that are connected to a portable recorder that logs every heartbeat while you go about daily activities.

What Does a Holter Monitor Show?

A Holter cardiac monitor is typically worn during regular daily activities so your clinician can identify irregular heartbeat patterns (heart arrhythmias) that may be causing symptoms such as palpitations, dizziness, fatigue, chest discomfort or passing out.

Holter Monitor VS ECG

Because the recording covers 24 to 48 hours (and sometimes longer), a Holter monitor test is more likely to detect intermittent abnormal rhythms than a standard ECG.

What can a Holter monitor detect?

It can detect arrhythmias like atrial fibrillation, supraventricular tachycardia, pauses, bradycardia, premature beats, and patterns linked to symptoms you document.

Can a Holter monitor detect anxiety?

It does not diagnose anxiety directly, but it can show whether symptoms thought to be anxiety-related correspond to abnormal rhythms. So while it cannot detect anxiety itself, it may help distinguish anxiety symptoms from cardiac rhythm causes by correlating your diary of when you feel anxious with recorded beats.

How does a Holter monitor work?

Small adhesive electrodes are placed on your chest using sticky pads that are connected by five leadwires to a lightweight recorder about the size of a pager. The recorder continuously logs your heart’s electrical activity. You’ll keep a diary of symptoms and activities so your physician can correlate events with the tracing.

Holter monitor vs event monitor

If your clinician is deciding between devices, they may explain the difference between Holter monitor and event monitor: a Holter monitor records continuously for a set period (typically 24–48 hours), while an event monitor records intermittently over weeks, triggered by symptoms or automatic detection.

What should I expect during Holter monitoring?

• The placement visit usually lasts 15–20 minutes.
• Five sticky pads with wires on them will be attached to your chest to detect and record heart rhythm.
• The wires connect to a small recorder worn on your belt, pocket or strap.
• You may be asked to keep a diary with specific info such as when you feel anxious, are experiencing symptoms or suspect an event.
• Complete instructions will be provided when the monitor is placed on you. What should you not do while wearing a Holter monitor? Generally, continue normal daily activities to capture typical heart rhythms, but there are some restrictions while wearing a Holter monitor.
• Do not shower, bathe, or swim while the device is on, as water can damage the electronics and loosen electrodes.
• Avoid saunas, hot tubs, and activities that cause heavy sweating under the electrodes.
• Do not apply lotions or oils to the chest where electrodes are placed.
• Avoid contact sports or movements that could pull off electrodes. It's important to keep the recorder and wires secure during the testing period.
• Avoid placing the recorder directly against powerful speakers or industrial magnets. Strong magnets and certain security systems are unlikely to interfere, but this is still recommended.

Can I use my cell phone while wearing a Holter monitor?

Yes - cell phones, microwaves and most household electronics are permissible. It is recommended you keep your phone a few inches from the recorder when possible. There is no risk of electric shock.

How do you sleep with a Holter monitor on?

Sleep on your back or the side opposite the recorder to reduce tugging on lead wires. Secure any slack in the wires with the provided tape, and place the recorder in a pouch or at your waist to prevent pulling during sleep. Keep the device dry and avoid heated blankets that may cause sweating under electrodes. If you awaken with discomfort or a loose electrode, re-secure it as instructed and note the time in your diary. These tips help ensure accurate Holter monitor test results overnight.

How Long Do Holter Monitor Test Results Take?

The physician who ordered the Holter monitor should have results within 24 to 48 hours after monitoring is complete. You may be able to see results in your MyChart account as soon as they come in, but your provider can go over them with you to break everything down.

If concerning or life-threatening rhythms are detected, the ordering physician is alerted promptly and you will be contacted as soon as possible with further instructions.