Holter Monitoring
Ambulatory Electrocardiography...
What is Holter monitoring?

A Holter monitor is a small, portable machine that continuously records the heart's rhythm and activity. The monitor is usually worn for 24 - 48 hours to determine how the heart responds to normal activity.This allows the monitor to record your heart for a longer time than an EKG.It also helps to diagnose the problem of heart rhythms during certain activities such as sleeping / physical exertion.

Why the Test is Performed

Indications of this test are:

To diagnose palpitation without a definite diagnosis obtained through resting ECG like in case of unexplained palpitations/ probability of Atrial fibrillation or flutter /Multifocal atrial tachycardia / Paroxysmal supraventricular tachycardia / Ventricular tachycardia
To diagnose / to rule out cardiac reasons for fainting / dizziness
To diagnose bradyarrythmia - slowing of heart rhythm
To evaluate the cause of prolonged fatigue
After heart attack with moderate to severelyreduced heart function
Monitoring the patient being known case of arrhythmia – on oral antiarrythmic treatment or in post ablation status.

There is no special preparation for the test. 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.Some people may need to have their chest shaved so the electrodes can stick.

Precautions to be taken during the test
While wearing the device, avoidElectric blankets / High-voltage areas / Magnets / Metal detectors.
You should be sure not to let the monitor get wet.
There are no risks associated with the test. It is a painless test.

Normal variations in heart rate occur with activities. A normal result is no significant changes in heart rhythms or pattern.Abnormal results may include various arrhythmias. 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.

Holtermonitoring: records cardiac electrical activities for entire time you're wearing it.
Event monitor / Post Event monitor: An event monitor records your heart's electrical activity only at certain times while you're wearing it. You have to trigger the monitor when you feel the symptoms.
Auto trigger Event Monitor: It is just like an Event monitor having feature to trigger the monitor automatically when heart rhythm becomes faster / slower than normal. You can also do it manually.
Memory loop recorder: It captures short period of time prior to the moment you trigger the recording & after wards.
Latest technology is ELR & ILR. It is patient friendly. It is wireless and water resistant. It is having automatic transmission – connected via satellite.
How the Test is done

Electrodes (small conducting patches) are stuck onto your chest which in turn are 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.Your doctor will start the monitor. You are instructed to keep a diary and explained to note down the period of discomfort and specific period & activity. You are asked to continue with your daily routine activity. You may be asked to exercise while being monitored if your symptoms have occurred in the past while you were exercising.

You'll be trained to replace the electrodes if they fall off or become loose.Electrodes must be firmly attached to the chest so the machine gets an accurate recording of the heart's activity.

After 24 - 48 hours, you will return the monitor to your doctor's office.The doctor will look at the records and see if there have been any abnormal heart rhythms. He will also make a reference of your activity notes to match any abnormal rhythm during the period.

Holter Monitoring Device