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Holter Monitor (24-Hour Electrocardiogram Monitoring)

The Holter monitor and event recorders are wearable types of electrocardiograms (EKG) used to  monitor heart function. Your cardiologist may recommend these tests if you show irregular heartbeat (arrhythmia) or other heart condition symptoms. 

UPMC cardiologists have extensive experience using Holter and event recorder monitors to diagnose heart conditions that may not be fully diagnosed in a resting EKG.



What Is a Holter Monitor?

A Holter monitor is a wearable device that performs an electrocardiogram (EKG) while you go about your daily activities. It helps your cardiologist determine if certain activities cause your heart rate to beat irregularly.

How does a Holter monitor work?

The Holter monitor measures and records your heart rhythm continuously for a period of 24 to 48 hours. Some monitors have a feature that you can activate only when symptoms begin to occur. Your cardiologist will read the EKG report generated by the monitor.

How do I wear a Holter monitor?

Electrodes will be attached to your chest and abdomen and then attached to the Holter monitor with lead wires. The monitor box may be worn over your shoulder like a shoulder bag, or it may clip to your belt or pocket. Some newer versions can be attached directly to your chest.

After you have been hooked up to the monitor and given instructions, you will return to your usual activities, such as work, household chores, and exercise, unless your doctor instructs you differently. You will keep a diary of your activities during the recording period, writing down the date and time of your activities and if any symptoms, such as dizziness, palpitations, or chest pain, occur. This will allow your cardiologist to identify problems that occur during certain activities.

What is the goal of wearing a Holter monitor?

The Holter monitor allows your cardiologist to measure your heart rhythm when a standard resting EKG does not provide enough information to explain your symptoms and make an accurate diagnosis.

What is the advantage of wearing a Holter monitor?

A Holter monitor allows your cardiologist to measure your heart rhythms based on “real-life” activities. This is a more precise diagnosis than you would get from a standard resting EKG.

How common is the Holter monitor test?

Holter monitoring is one of the most common tests for diagnosing heart rhythm problems.

What are the different types of Holter monitors?

  • Traditional Holter monitors continuously monitor heart activity for 24-48 hours.
  • Extended-wear monitors can be used for a longer period, up to two weeks or more.
  • Event monitors use a smaller recording device that only records when symptoms occur.
  • Wireless Holter monitors record heart electrical activity for a set time, then send the data to the doctor's office using a cell phone.

Conditions we treat with Holter monitors

Holter monitors are used to determine the cause of symptoms that include:

  • Dizziness.
  • Fainting.
  • Low blood pressure.
  • Prolonged fatigue.
  • Palpitations.

Why Would I Need a Holter Monitor?

You may be a candidate for a Holter monitor test if you have:

  • Chest pain not reproduced with exercise testing.
  • Symptoms that may be heart-related, such as fatigue, shortness of breath, dizziness, or fainting.
  • An irregular heartbeat or palpitations.
  • Cardiomyopathy.
  • Had a heart attack.
  • Have an implanted pacemaker.
  • Have had treatment for arrhythmia.

What are the benefits of a Holter monitor?

Some abnormal heart rhythms may occur infrequently or only when you are doing certain activities. These cannot be recorded during a standard at-rest EKG.

A Holter monitor test is a simple, non-invasive test that allows your cardiologist to measure your heart rhythm when you are living your everyday life.

Can a Holter monitor detect anxiety?

A Holter monitor does not directly detect anxiety, but it may measure an abnormal heart rhythm that occurs during an anxiety or panic attack.

Does a Holter monitor detect a blockage?

A Holter monitor can detect inadequate blood supply, which can indicate a blockage. It may be prescribed for you if you have had a recent heart attack. The goal is to check for new blockages.

What Are the Risks and Complications of Holter Monitor Testing?

The Holter monitor is an easy way to check your heart’s function. The risk of complications is very low.

You may have some difficulty keeping the electrodes stuck to your skin and removing them may be uncomfortable. If the electrodes are on for a long time, some itchiness or blistering may occur.

What Should I Expect From the Holter Monitor Test Procedure?

The procedure requires no preparation and is usually done on an outpatient basis. However, you will need to shower beforehand since you cannot get the monitor wet after it is on.

What should I avoid while I am wearing a Holter monitor?

  • Magnets.
  • Metal detectors.
  • Electrical appliances such as shavers, toothbrushes, and microwave ovens.
  • Swimming.
  • Showering or bathing.

Keep cell phones at least six inches away from the monitor box.

How long does it take to place my Holter monitor?

A Holter monitor takes about 10-20 minutes to place. This appointment includes putting on the electrodes, testing the monitor, and giving you instructions on how to care for the device.

Your second appointment will be about 30 minutes and include removing the monitor, downloading the data, and discussing your results.

Why Choose UPMC for Holter Monitor Care?

The cardiologists at UPMC are experts at using cardiovascular testing to accurately diagnose heart conditions. Our team of experts will develop a treatment plan to manage your heart health and improve your symptoms.


Last reviewed by a UPMC medical professional on 2024-10-01.