What Is A Holter Monitor?

A Holter monitor is a type of portable electrocardiogram (ECG). It records the electrical activity of the heart over 24 hours or longer while you are away from your healthcare provider’s office.

A standard or resting ECG is one of the simplest and fastest tests used to check the heart. Small, plastic patches (electrodes) are put on certain points on the chest and belly (abdomen). The electrodes are connected to an ECG machine by wires. The electrical activity of the heart can be measured, recorded, and printed. No electricity is sent into the body.

Natural electrical impulses help control 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. It also checks the rhythm of the heartbeats (steady or irregular). It records the strength and timing of the electrical impulses. Changes in an ECG can be a sign of many heart-related conditions.

We will advise a Holter monitor ECG if you have symptoms such as dizziness, fainting, tiredness, palpitations, or a resting ECG doesn’t show a clear cause. A Holter monitor may also be ordered if your resting ECG shows a problem but more information is needed.

Conventional Holter monitoring uses the same kind of ECG electrode patches on your chest and the electrodes are connected by wires to a small monitor box (portable recording device). Newer devices don’t use electrode patches and wires. They are a single unit that attaches to the chest like a patch.

We exclusively use Patch Electrodes to do Holter monitoring as they have numerous advantages over a cumbersome conventional wired monitor.

You can see the simplicity in the device by comparing the 2 images below

1) CONVENTIONAL HOLTER MONITOR

2) MODERN, STATE- OF-THE ART PATCH ELECTRODES FROM WEBCARDIO

• The new normal of AMBULATORY Cardiac monitoring in India
• Never misses a single abnormal beat
• Eliminates the risk of COVID-19 infection
• Ensures better compliance due to enhanced convenience
• India’s No.1 Ambulatory Cardiac Monitoring solution with unmatched clinical accuracy

Why might I need a Holter monitor?

Some reasons why I might recommend a Holter monitor recording include (but not limited to):

• To evaluate symptoms that may be heart-rhythm related. (Symptoms can include palpitations, dizziness, tiredness, sudden shortness of breath or fainting).
• To identify irregular heartbeats or palpitations.
• To assess your risk for future heart-related events in certain conditions. These conditions can include thickened heart walls (hypertrophic cardiomyopathy), sometimes after a heart attack that caused weakness of the left side of the heart.
• When there is a suspicion that you might be born with abnormal or extra electrical connections in your heart leading to a situation called pre-excitation- often referred to as Wolff-Parkinson-White syndrome.
• To see how well a pacemaker is working.
• To find out how well treatment is working for complex abnormal heart rhythms.

• To see how fast or slow your heart rate gets during the day and night, during exercise, emotions, stress of day-to-day life and sometimes to see if you have any gaps (termed pauses) in your heart rhythm.

There may be other reasons that are not listed above when I might recommend this test and I will explain this in detail to you before commencing the test.

What are the risks of a Holter monitor?

The Holter monitor is an easy way to check the heart’s function.

Risks of a Holter monitor are minimal and rare.

• It can be hard to keep the patch stuck to your skin for 3 days to secure it so as not to miss any readings (good contact you’re your skin for all the four limbs of the patch is very important to have accurate readings.
• It may be uncomfortable when the patch electrodes and tape are taken off.
• If the electrodes are on for a long time, they may cause skin irritation or blistering.

The WEBCARDIO patch seldom causes any of the above issues and it is also water proof so that you can have shower/swim as the device recordings will not be affected by contact with water. However, when you are drying yourself, please take note that you don’t rub on top of the device as it will interpret as an abnormal “noise” that will affect the ECG recording.

What happens during a Holter monitor?

A Holter monitor recording is often done on an outpatient basis.

Generally, a Holter monitor recording follows this process:

• You will be asked to remove any jewellery or other objects that may interfere with the recording.
• You will be asked to remove your clothing from the waist up so that the patch can be attached to your chest. The technician will give you privacy by covering you with a sheet or gown and exposing only the necessary skin.
• The areas where the patch is placed are cleaned. In some cases, hair may be shaved or clipped so that the electrodes will stick closely to the skin.
• The newer device we use (WEBCARDIO PATCH) simply sticks to your chest and we use additional medical grade adhesive tapes to keep it in place during all activities through the day and night.
• You can return to your normal activities once you have been hooked up to the monitor box and given instructions. These are activities such as work, household chores, and exercise. This will enable us to find problems that may only happen with certain activities.
• You may be told to keep a diary of your activities while wearing the monitor. Write down the date and time of your activities, especially if any symptoms such as dizziness, palpitations, chest pain, or other previously experienced symptoms happen.

What happens after a Holter monitor?

After the completion of recording (usually 3 or 7 days) the WEBCARDIO patch can be removed and discarded.

All the recordings made by the device will be continuously transferred to the WEBCARDIO app and then on to our master computer. At the completion of the recording, we will analyse the entire recording and give you a comprehensive report and advise on next steps based on the findings of the test.

Often it just involves adding a drug (such as beta blockers or anti-arrhythmic drugs), sometimes we might recommend a pacemaker or defibrillator implant if you had very slow heart beats or very fast heart beats respectively causing fainting.