Holter Monitor

What is it?

A technician uses a mouse to control a display filled with medical information behind a holter monitor device with many leads

Holter monitoring is used to determine how the heart responds to normal activity.

The heart normally contracts regularly due to an orderly spread of electrical activity from an area of specialized heart cells called "pacemaker cells" to the rest of the heart. An electrocardiogram (ECG) represents a surface mapping of the electrical activity of the heart.

There is a normal pattern of changes in the electrical activity of the heart with activities such as exercise. Normal variations in electrical activity occur with various activities. With different types of heart disease, there will be various other patterns of changes in the electrical activity of the heart during normal daily activity. The resulting changes in the rate and shape of the surface mapping of the electrical activity during normal daily activity is continuously recorded on the holter monitor.

Reason for Test

  • Documents and describes abnormal electrical activity in the heart during daily activities to help doctors determine the condition of the heart.
  • Helps determine the cause of symptoms like palpitations, heart racing, fatigue & weakness, dizziness, chest pains, shortness of breath and blackouts. It is also used to exclude a heart rhythm cause of strokes.
  • Helps determine the best possible treatments.

How should I prepare for it?

You should wear loose clothing so that the monitor can be worn easily under your clothes.

You should take a bath or shower before coming to your appointment as you will not be able to do so while wearing the holter monitor.

Do not apply any body lotion or oil to your skin before the appointment, as this makes it difficult to attach the electrodes.

Bring a list of all present medications.

What will happen during the test?

Prior to the test, you will be asked to sign a consent form. Please read it carefully and if you have any questions, ask the technologist. He or she will explain the procedure before it begins.

Several electrode pads will be placed on your chest to obtain an ECG. Men may need to have small areas of their chest shaved. These electrode pads will be connected to an ECG monitor to record a resting electrocardiograph. The holter monitor leads will be connected to the electrode pads. The monitor (recording device), which is worn around your waist, is lightweight and battery-operated.

The technologist will begin the recording and ensure that the electrodes and monitor are working properly. You will receive a booklet to write down any symptoms you have during the monitoring period.

Perform your usual activities while wearing the monitor. Write down the exact times in the booklet when you perform specific activities, e.g., when you exercise, climb stairs, have sex, smoke cigarettes, sleep, get emotionally upset, take medications, or perform other activities. If you have any symptoms of heart problems, such as dizziness, fainting, chest pain, or irregular heart beat, write down the exact time and duration of the symptom in the booklet. The accuracy and usefulness of this test depend on how carefully you record your activities and symptoms and the times they occurred.

When sleeping, try to stay on your back with the monitor carefully positioned at your side or on the night table next to your bed so that the electrodes are not pulled off.

If one of the electrodes or lead wires comes loose, press on the centre of each electrode to see if you can restore the contact. If one of the electrodes comes off and you have difficulty replacing it, call 519-624-3511 for assistance.

The recording device must not get wet. Do not bathe, shower or swim. Do not use an electric blanket, electric shaver, a heating device for a waterbed or have a X-ray done while wearing the monitor. Signals from these types of electronic equipment can sometimes interfere with the recording.

Your physician has determined whether you need to wear the monitor for 24, 48 or 72 hours and the technologist will give you a return time to have the monitor removed accordingly. You must return at the assigned time so that the data in the monitor can be downloaded.

A written report will be sent to your physician upon completion and analysis of the test. Your physician will then explain the test results to you.

Answers to common questions

How long will the test last? The first portion of the test lasts approximately 30 minutes. You can then leave but you must return at the designated date and time to have the holter monitor removed and the data downloaded, which takes approximately 30 minutes.

Will I experience anything during the test? The electrode and tape sites may itch slightly while wearing the monitor. The recording unit is very lightweight, so carrying it is usually not uncomfortable.

Is there a cost to me for the test? No. If you have OHIP coverage, as long as the test is ordered for a medical condition, there is no charge to you for the test. Sometimes the test is ordered for an insurance assessment or ministry of transportation request etc., under such circumstances, there may be a charge to you or your insurance company for the test since it was not ordered for a medical indication by your doctor.

Are there any adverse reactions to wearing a holter monitor? The skin on your chest may, on rare occasions, become slightly irritated when the electrodes and tape are removed. The irritation is caused by the conductive gel on the electrodes reacting with the skin.

How do I remove the adhesive residue from the skin on my chest? Use baby oil to remove the adhesive residue from the skin on your chest. DO NOT use perfumed items or products containing alcohol since this may result in severe skin irritation.

Download a Holter Monitor Diary

Your Cardiac Investigation Team

Cambridge Cardiac Care
150 Hespeler Rd.
Cambridge, Ontario N1R 6V6
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Cambridge Cardiac Care is located in the heart of Waterloo Region in downtown Cambridge.

Cambridge Cardiac Care serves patients throughout southwestern Ontario, including Cambridge, Kitchener, Waterloo, Guelph, Brantford, Paris, Fergus, Elora, Elmira, Owen Sound, Kincardine, and Stratford.