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A Holter (HOLE ter) monitor is a small device (about the size of a deck of cards). It is used to get a 24-hour record (tracing) of your child’s heart rate and rhythm. The monitor will show anything unusual about his or her heartbeat. It does not hurt. How the test is doneYour child will come to the hospital to get his Holter monitor. After the monitor is recording, you may take him home. The skin on your child’s chest will be cleaned in three to five areas with an alcohol swab. A sticker (electrode) attached to a wire by a snap will be placed on the chest in each of the cleaned areas (Picture 1). The wires will then be attached to the Holter monitor, which your child will wear inside a small carrying case. The case fits on a belt at the child’s waist or over the shoulder on a strap. The Holter monitor collects and saves a record of your child’s heart beats. You will hear a series of beeps for one minute when the monitoring period starts. The beeps tell you the device is recording. A green light on the monitor will flash during the 24-hour recording period. The monitor will shut off by itself at the end of the 24 hours. You will be given a diary to record your child’s activities while he or she wears the monitor. Please record times asleep and awake, physically active and quiet times, and times that the child takes medicine. Also, record any symptoms that occur while your child is wearing the monitor. You will press the square button on the carrying case to document the symptom in the recorded data. Risks and possible complicationsPatients may have mild reactions to the electrodes. This can cause redness, itching or a faint rash at the site of the electrode that will fade with time after the electrodes have been removed. If an electrode loosens during monitoring, please replace it with a new (spare) electrode you will be given at the time you get the monitor. If the wire comes off, simply snap it back onto the electrode. You will be given a diagram to show the correct color and location of each wire. Special instructions
After the testAfter the monitoring period is finished, remove the electrodes from your child’s chest and throw them away. Immediately place the wires, Holter monitor, case, strap and diary in the self-addressed, postage-paid priority mail box that you got along with the Holter monitor and mail back to Nationwide Children’s Hospital. ActivityYour child should do all normal activities while wearing the monitor unless his or her doctor tells you otherwise. It takes about 10 days for the test results to be completed once we get the monitor back. When the report is ready, your child’s doctor will discuss the test results with you, along with any plans for more medical care. Holter Monitor (PDF) HH-III-122 2/16 Copyright 2016, Nationwide Children’s Hospital
The Holter monitor is a type of portable electrocardiogram (ECG). It records the electrical activity of the heart continuously over 24 hours or longer while you are away from the doctor's office. A standard or "resting" ECG is one of the simplest and fastest tests used to evaluate the heart. Electrodes (small, plastic patches that stick to the skin) are placed at certain points on the chest and abdomen. The electrodes are connected to an ECG machine by wires. Then, the electrical activity of the heart can be measured, recorded, and printed. No electricity is sent into the body. Natural electrical impulses coordinate contractions of the different parts of the heart. This keeps blood flowing the way it should. An ECG records these impulses to show how fast the heart is beating, the rhythm of the heart beats (steady or irregular), and the strength and timing of the electrical impulses. Changes in an ECG can be a sign of many heart-related conditions. Your healthcare provider may request a Holter monitor ECG if you have symptoms, such as dizziness, fainting, low blood pressure, ongoing fatigue (tiredness), and palpitations and a resting ECG doesn’t show a clear cause. You wear the same kind of ECG electrode patches on your chest, and the electrodes are connected by wires to a small, portable recording device. Certain arrhythmias (abnormal heart rhythms) may occur only now and then. Or, they may occur only under certain conditions, such as stress or activity. Arrhythmias of this type are hard to record on an ECG done in the office. Because of this, the healthcare provider might request a Holter monitor to get a better chance of capturing any abnormal heartbeats or rhythms that may be causing the symptoms. Some Holter monitors also have an event monitor feature that you activate when you notice symptoms. You will get instructions on how long you will need to wear the monitor (usually 24 to 48 hours), how to keep a diary of your activities and symptoms during the test, and personal care and activity instructions, which include keeping the device dry while you are wearing it. Why might I need a Holter monitor?Some reasons for your healthcare provider to request a Holter monitor recording or event monitor recording include:
There may be other reasons for your healthcare provider to recommend the use of a Holter monitor. What are the risks of a Holter monitor?The Holter monitor is an easy way to assess the heart’s function. Risks associated with the Holter monitor are rare. It can be hard to keep the electrodes stuck to your skin, and extra tape may be needed. It may be uncomfortable when the sticky electrodes and tape are taken off. If the electrodes are on for a long time, they may cause tissue breakdown or skin irritation at the application site. There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before wearing the monitor. Certain factors or conditions may interfere with or affect the results of the Holter monitor reading. These include, but are not limited to:
How do I get ready for a Holter monitor?
What happens during a Holter monitor?A Holter monitor recording is generally done on an outpatient basis. Procedures may vary depending on your condition and your healthcare providers practice. Generally, a Holter monitor recording follows this process:
What happens after a Holter monitor?You should be able to go back your normal diet and activities, unless your healthcare provider instructs you differently. Generally, there is no special care after a Holter monitor recording. Tell your healthcare provider if you develop any signs or symptoms you had before the recording (for example, chest pain, shortness of breath, dizziness, or fainting). Your healthcare provider may give you other instructions after the procedure, depending on your particular situation. Next stepsBefore you agree to the test or the procedure make sure you know:
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