Holter monitoring is the continuous recording of the heart’s electrical activity for 24-48 hours or longer. It is the gold standard method for detecting intermittent rhythm disorders.
What is Holter Monitoring?#
A Holter is a portable ECG recording device. It continuously records heart rhythm during daily activities. This allows detection of rhythm disorders that cannot be captured on short-term ECG.
Advantages of Holter:
- Continuous recording
- Monitoring during daily activities
- Symptom-rhythm correlation
- Detection of intermittent arrhythmias
Holter Indications#
Symptom Evaluation#
- Palpitations
- Dizziness
- Fainting (syncope)
- Presyncope
- Unexplained fatigue
Arrhythmia Diagnosis and Follow-up#
- Suspected atrial fibrillation
- Supraventricular tachycardia
- Ventricular arrhythmia
- Bradycardia
- Pacemaker function check
Other Indications#
- AF screening after stroke
- Antiarrhythmic drug efficacy
- Post-ablation follow-up
- Arrhythmia screening in heart failure
Types of Holter#
24-Hour Holter#
- Most commonly used
- Covers daily activities
- Evaluates day and night rhythm
48-72 Hour Holter#
- Longer recording duration
- Detection of rare arrhythmias
- Higher diagnostic yield
Event Recorder#
- Worn for 2-4 weeks
- Records at time of symptoms
- For very rare arrhythmias
Implantable Loop Recorder#
- Placed under the skin
- Records up to 3 years
- For unexplained syncope
How is Holter Applied?#
Preparation#
- No special preparation required
- Chest area should be clean
- Comfortable clothing preferred
Application Process#
- Skin preparation: Cleaning and shaving
- Electrode placement: 5-7 electrodes
- Device connection: Hung on waist or shoulder
- Patient education: Keeping a diary
Recording Duration#
- Standard: 24 hours
- Extended: 48-72 hours
- Event recorder: 2-4 weeks
Precautions During Holter#
Things to Do#
- Continue normal daily activities
- Keep a symptom diary
- Note activity times
- Keep device dry
Things to Avoid#
- Shower or bath
- Touching electrodes
- Magnetic fields
- Excessive sweating
Holter Results#
Evaluated Parameters#
| Parameter | Description |
|---|---|
| Total beat count | ~100,000 in 24 hours |
| Average heart rate | Day/night separate |
| Minimum/maximum rate | Bradycardia/tachycardia |
| Arrhythmia count | PAC, PVC, others |
| ST changes | Ischemia findings |
Common Findings#
- Sinus arrhythmia (normal variant)
- Premature atrial complexes (PAC)
- Premature ventricular complexes (PVC)
- Atrial fibrillation episodes
- Supraventricular tachycardia
Frequently Asked Questions#
Can I shower while wearing a Holter?
Does Holter affect daily activities?
When do Holter results come out?
Is Holter painful?
Can I sleep while wearing a Holter?
Appointment and Contact#
If you would like to schedule an appointment for Holter monitoring:
📍 Avrasya Hospital - Beştelsiz Mah. 101. Sokak No:107, Zeytinburnu, Istanbul
📞 Phone: +90 212 665 50 50 (Ext: 4012)
This content has been prepared by Assoc. Prof. Dr. Habib Çil for general informational purposes. Please consult a cardiology specialist for definitive diagnosis and treatment.
Related Diagnostic Tests#
Other diagnostic tests related to Holter monitoring:
- EKG - Electrocardiography
- Ambulatory Cardiac Monitoring - Extended rhythm monitoring
- Electrophysiology Study - Arrhythmia diagnosis
- Echocardiography - Heart ultrasound
- Ablation - Catheter ablation