What to Expect When a Cardiovascular Doctor Orders a Holter Monitor

When a cardiovascular doctor recommends Holter monitoring, many patients are unfamiliar with the test.  Understanding what to expect can greatly reduce patient anxiety about this procedure.

What Exactly is a Holter Monitor?

A Holter monitor is a device patients wear to track heart rhythm.  Test results are important tools in helping cardiologists make diagnoses.  According to the Mayo Clinic, the test is noninvasive and painless.

This portable device is a type of electrocardiogram (ECG).  The American Heart Association indicates that it is roughly the size of a small camera and records heart activity for 24 or more hours.

Changes in an ECG can signal various cardiac conditions.  A Holter monitor records electrical impulses that coordinate heart contractions.  The information it collects shows:

  • How fast a heart is beating
  • A steady or an irregular beat rhythm
  • Timing and strength of impulses as they travel through the heart

Why Cardiologists Order It

A standard ECG in a doctor’s office only records heart activity at a single point in time.  Holter monitoring allows cardiologists to evaluate heartbeats over an extended period.

The data collected provides physicians with information such as:

  • Whether current medications are effective
  • Why a patient experiences symptoms like dizziness, feeling faint, or sensing a skipped heartbeat or a racing heart
  • Whether the heart is getting a sufficient supply of oxygen

Doctors order this test when symptoms such as low blood pressure, dizziness, fainting, fatigue, and heart palpitations persist, but a resting ECG cannot detect a precise reason, Johns Hopkins Medicine reports.  Other common reasons include evaluating chest pain not duplicated with exercise testing, assessing the risk of future cardiac issues, monitoring heart rate after a heart attack, and determining whether an implanted pacemaker is effective.

The Monitoring Process

At a patient's appointment, a staff member will ask that jewelry and any other objects that could interfere with the test be removed.  The patient removes clothing from the waist up and changes into a gown so that a technician can affix electrodes to the chest.

It is sometimes necessary to shave to clip hair so that the electrodes will adhere properly.  The technician also attaches electrodes to the abdomen.  Wires connect them to the Holter device, which patients wear over the shoulder, around the waist, or clipped to a pocket or belt.  Since the device operates on batteries, it is important that patients carry extra batteries and know how to change them.  Patients cannot swim, shower, or bathe while wearing the monitor.

After getting instructions, a patient returns to normal activities unless the physician advises otherwise.  Monitoring requires keeping a patient diary of activities and symptoms noted that will be matched to the data collected.  At the end of the test, the individual returns to the practice to have electrodes removed.

 

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