GENERAL INFORMATION:

What is a Holter monitor? 

• A Holter monitor is also called an ambulatory electrocardiography (ECG) monitor. It is a small battery-operated device that you wear. The monitor shows your heart's electrical activity while you do your usual activities. The monitor will show how fast your heart beats, and if it beats in a regular pattern. A normal heartbeat usually does not go above 100 beats per minute. Normally, your heartbeat is controlled by well-ordered electrical signals, and occurs with movement of your heart muscle. If you have a heart problem, the signals in your heart may not function properly. Your heart may not beat properly causing dizziness, chest pain, or even death.
  
• A Holter monitor can show how your heart adjusts to changes in activities, such as when you exercise. Electrodes (wires) with sticky pads on the end are attached to the monitor. These sticky pads are placed on certain areas of your chest. The electrodes pick up the electrical signals from your heart, and the monitor records them. The recorded signals may help your caregiver learn if you have heart damage or heart problems. The monitor may help your caregiver learn the cause of your symptoms. The monitor may also help you and your caregiver learn if you are at risk for heart problems.

Why may I need to use a Holter monitor? You may need to use a Holter monitor for any of the following reasons:

• You have had a previous heart attack: A Holter monitor may show if you are at risk for having another heart attack. The monitor may show if your heart is getting enough oxygen even if you have no symptoms. The monitor may show when these episodes happen, and how your heart responds.
  
• You have symptoms of a heart problem or abnormal ECG findings: A Holter monitor may show if a heart problem is causing your symptoms. These symptoms include chest pain, dizziness, fainting episodes, fast or pounding heartbeat, weakness, or confusion (trouble thinking clearly). Findings on an ECG such as irregular heartbeats, may be seen better using a Holter monitor.
  
• You are scheduled for heart surgery: If you are about to have heart surgery, your caregiver may ask you to wear a Holter monitor. The monitor may also be needed after having your heart surgery.
  
• You are a pregnant female with irregular heart beats: Your caregiver may ask you to wear a Holter monitor if you have strong, pounding heartbeats. Irregular heartbeats may harm yours and your baby's health. You may also be asked to wear the monitor during pregnancy if you have heart disease. Pregnancy may worsen your heart problem. The monitor may help show if you and your baby are in danger.
  
• You are starting on new heart medicines: The monitor may show if certain heart medicines are working well for you. These heart medicines may be used to speed up or slow down your heartbeat. The monitor can show if your heart medicine is controlling your heartbeat as it should.
  
• You are wearing a pacemaker: A pacemaker is a small device that helps control your heartbeat. It may slow your heartbeat down, speed it up, or make it regular. A Holter monitor may be used to check if your pacemaker is working properly. The monitor may also check if your pacemaker controls your heartbeat while doing your usual activities.

How do I wear a Holter monitor and how long do I need to wear it? 

• Caregivers will clean your chest. If you are male, some of your chest hair may need to be shaved off. Sticky pads are placed on certain areas of your chest. Normally between 3 to 8 sticky pads may be used. Your caregiver may tape the electrodes to your skin to keep them in place. Wear loose-fitting clothes while wearing your monitor so you can move freely.
  
• The electrodes will be plugged into the monitor. The monitor will be turned on and will record electrical signals constantly for 24 to 48 hours. Depending on your symptoms, you may need to use your monitor for up to seven days. The monitor will be put in a pouch for you to carry.

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

• Keep a diary: List all the activities you do and any symptoms you have while wearing your monitor. Use a clock to note the exact time of your activities and symptoms. Keeping a diary of your activities and symptoms will help your caregiver when reading your ECG record. Your diary may help your caregiver learn what is causing your abnormal heart activity. Take note of activities such as eating, exercising, sleeping, urinating, and having bowel movements. Include intake of herbal or prescribed medicines, or alcoholic drinks. Take note of any of the following symptoms you may have and write them down in your diary:
  
  • Chest pain or discomfort.
    
  • Dizziness or passing out (fainting). Try to note how long you passed out, and if you had symptoms before or after your fainting episode. Write down the activity you were doing before you fainted.
    
  • Irregular heartbeats such as a fluttery feeling in your chest.
    
  • Shortness of breath or trouble breathing.
    
  • Strong, pounding heart beats.
    
• Do not wet your chest: Wetting your chest may remove the sticky pads or electrodes. When the sticky pads or electrodes come off your chest, the monitor cannot record your heart rhythm. Do not take a shower while wearing your Holter monitor. You will need to take sponge baths while wearing your monitor.

When should I call my caregiver?  Call your caregiver if:

• Electrodes or sticky pads come off your chest.
  
• You have a headache, feel dizzy or lightheaded, or have passed out.
  
• You have skin redness and a rash where your sticky pads are.
  
• Your monitor stops working.
  
• You have questions about using the Holter monitor.

When should I seek immediate help? Seek care immediately or call 911 if:

• You are pale (less color in your skin) and have cold, sweaty skin.
  
• You have a heavy or squeezing feeling in your chest that lasts more than a few minutes.
  
• You have pain in your chest that spreads to your shoulders, neck, or arms.
  
• You have trouble breathing.