Holter Monitoring

Overview :

The technician affixes electrodes on the surface of the skin at specific areas of the patient's chest, using adhesive patches with special gel that conducts electrical impulses. Typically, electrodes are placed under each collarbone and each bottom rib, and several electrodes are placed across the chest in a rough outline of the heart. The electrodes are attached to a portable electrocardiographic device called a Holter monitor, which records the electrical activity of the heart over 24-48 hours. The device is worn over the patient's shoulder or attached to a belt around the waist.

The Holter monitor records the continuous electrical activity throughout the course of the day, while the patient carries out his or her daily activities. During this time, the patient also keeps a detailed log or diary, recording his or her various activities, such as exercise, eating, sleeping, straining, breathing too hard (hyperventilating), and any stressful situations. The patient also notes the time and circumstances of any symptoms-especially chest pain, dizziness, shortness of breath, heart palpitations, and any other signs of heart trouble. Some Holter monitors allow patients to record their symptoms electronically, highlighting the portion of the electrocardiogram recorded while the symptoms are occurring.

After 24-48 hours, the Holter monitor is removed. A computer-assisted analysis is performed on the electrocardiographic recording, and the doctor compares the recording against the patient's log to see if there is any correlation between electrocardiographic abnormalities and any of the patient's activities or symptoms. The physician makes a final interpretation.