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Holter Monitoring - Why and How test is performed

What is Holter monitoring?
Holter monitoring is a continuous recording of heart rhythm during normal activity, usually for 24-hours.

Why the test is performed?
  • The test is done to determine how the heart responds to normal activity, or in some cases, to cardiac medication. It may some
  • time be done on some people after a heart attack. This test will help the doctor evaluate the type and amount of irregular heart beats during regular activities, exercise and sleep. 
  • Normal variations in heart rate occur with activities but no significant alterations in the rhythm or ST segment elevations occur.
What are abnormal results?
Abnormal results may include various arrhythmias (any disorder of heart rate or rhythm). ST segment changes are alterations in the wave form of the electrical conduction pattern of the heart that may indicate the heart is not receiving enough oxygen and may also correlate with chest pain

The usual suspected conditions for which the test may be performed:
  • atrial fibrillation/flutter
  • atrial tachycardia
  • palpitations
  • fainting
How is the test is performed?
  • Electrodes (small conducting patches) are placed on the patients chest and attached to a small battery operated recorder that can be carried in a pocket or small pouch worn around the neck. The monitor is battery operated. 
  • The heart’s electrical activity is recorded (similar to the recording of an electrocardiogram), usually for a 24-hour period while you a diary of activities is kept during this period. 
  • The recording is then analysed by a heart specialist, a report of the heart’s activity is tabulated, and irregular heart activity is correlated with activity.
  • Electrodes must be firmly attached to the chest to permit accurate recording of the heart’s activity. Magnets, metal detectors, electric blankets, and high-voltage areas have to be avoided while wearing the holter device.
How to prepare for the test?
  • In adults there is no special preparation for the test. The recording will be started by the doctor, and instructions will be given on how to replace electrodes should they become loosened. Instructions are also given on how to record activities for the diary.
  • There is no discomfort associated with the test. Hair may be shaved if needed from the chest for electrode placement. 
  • The recorder is kept close to the body in a pouch worn around the shoulder or neck. Creams, oils, or powder should not be applied to the chest before the test. Wear loose and comfortable clothing.
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