24-Hour ECG (Holter Monitoring)

Introduction

A 24-hour ECG, also known as Holter monitoring, is a test that records your heart’s electrical activity over a full day. It helps detect abnormal heart rhythms (arrhythmias) that may not appear on a standard ECG.

Why is it Needed?

A Holter monitor is often prescribed if you experience symptoms such as: - Palpitations (irregular or fast heartbeats) - Dizziness or fainting spells - Chest discomfort - Unexplained fatigue

It helps doctors diagnose arrhythmias, monitor treatment effectiveness, and assess how your heart responds to daily activities.

How Does It Work?

  • Small electrodes are attached to your chest, connected to a portable device.
  • The monitor records your heart’s electrical activity continuously for 24 hours (or longer if needed).
  • You should carry on with your normal daily activities but avoid excessive sweating or water exposure.
  • Patients may be asked to keep a diary of symptoms.

Interpretation of Results

After 24 hours, a cardiologist analyzes the data to identify any abnormalities such as: - Atrial fibrillation (irregular heart rhythm) - Bradycardia (slow heart rate) - Tachycardia (fast heart rate) - Extra beats (ectopic beats)

Next Steps

Depending on the results, your doctor might: - Recommend further tests (such as an echocardiogram or stress test). - Adjust medications if a rhythm disorder is detected. - Suggest lifestyle changes or, in severe cases, interventions like a pacemaker.

Conclusion

A 24-hour ECG is a valuable tool to detect hidden heart problems. If recommended by your doctor, follow the instructions carefully to ensure accurate results.

Source recommendations

1. American Heart Association Guidelines for Ambulatory ECG Monitoring

  1. https://www.ahajournals.org/doi/10.1161/01.cir.100.8.886
  2. https://www.aafp.org/pubs/afp/issues/2000/0201/p884.html
  3. https://www.heart.org/en/health-topics/arrhythmia/symptoms-diagnosis--monitoring-of-arrhythmia/cardiac-event-recorder
  4. https://www.ahajournals.org/doi/10.1161/cir.0000000000000527
  5. https://www.jacc.org/doi/10.1016/S0735-1097%2899%2900354-X

2. European Society of Cardiology Guidelines on Cardiac Rhythm Management

  1. https://www.escardio.org/Sub-specialty-communities/European-Heart-Rhythm-Association-(EHRA)
  2. https://pubmed.ncbi.nlm.nih.gov/32860505/
  3. https://www.escardio.org/
  4. https://pubmed.ncbi.nlm.nih.gov/16935995/
  5. https://academic.oup.com/eurheartj/article/43/40/3997/6675633

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