24-Hour ECG Monitor (Holter Monitor)

Introduction

A 24-hour ECG monitor, also known as a Holter monitor, is a portable device used to continuously record your heart's electrical activity over an extended period. It helps doctors detect irregular heart rhythms (arrhythmias) and evaluate symptoms such as palpitations, dizziness, or unexplained fainting episodes.

Why is a 24-Hour ECG Monitor Used?

Your doctor may recommend a Holter monitor if: - You have episodes of irregular heartbeats (arrhythmia) that are not always captured during a standard ECG (which records for only a few seconds). - You experience heart-related symptoms, such as palpitations, chest pain, dizziness, or fainting, but previous ECGs were normal. - You need an assessment after a heart attack or to monitor the effectiveness of certain treatments (e.g., anti-arrhythmic drugs or pacemakers).

How Does It Work?

1. Electrode Placement: Small electrodes (stickers) are placed on your chest, connected to a small recording device worn on a belt or shoulder strap.
2. Continuous Recording: The monitor records your heart's electrical signals for 24 to 48 hours (sometimes longer if needed).
3. Activity Log: You may be asked to keep a diary, noting any symptoms and activities throughout the day.
4. Data Analysis: After the monitoring period, the device is returned to the clinic, where doctors analyze the recorded data to detect abnormalities.

What Can a Holter Monitor Detect?

• Atrial fibrillation (AFib) – a common irregular heartbeat that increases the risk of stroke.
• Bradycardia (slow heart rate) – indicating issues with the heart's electrical system.
• Tachycardia (fast heart rate) – which may be linked to stress, arrhythmias, or other heart conditions.
• Silent ischemia – reduced blood supply to the heart with no noticeable symptoms.
• Heart pauses or blocks – which may require a pacemaker.

Preparation and Precautions

• Wear loose-fitting clothing for comfort and to allow electrode placement.
• Avoid getting the device wet (no showers or swimming while wearing it).
• Follow your daily routine as usual, unless instructed otherwise.
• Record symptoms in a provided diary.

What Happens After the Test?

• The doctor will review the data and may recommend lifestyle changes, medication adjustments, or further testing based on the findings.
• If significant abnormalities are detected, immediate medical intervention may be required.

Conclusion

A 24-hour ECG (Holter monitor) is a valuable tool for detecting heart rhythm disturbances that may not appear during a short ECG test. It provides critical insights into your heart's function and helps guide effective treatment if needed.

Source recommendations

1. American Heart Association Guidelines on Arrhythmia Monitoring

1. https://www.heart.org/en/health-topics/arrhythmia
2. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
3. https://www.heart.org/en/health-topics/arrhythmia/symptoms-diagnosis--monitoring-of-arrhythmia/syncope-fainting
4. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
5. https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/tachycardia--fast-heart-rate

2. European Society of Cardiology Guidelines on Holter Monitoring and Arrhythmias

1. https://www.escardio.org/The-ESC/Press-Office/Press-releases/extended-monitoring-detects-more-arrhythmias-in-hypertrophic-cardiomyopathy
2. https://academic.oup.com/eurheartj/article/36/41/2793/2293363
3. https://www.escardio.org/Councils/Council-for-Cardiology-Practice-(CCP)/Cardiopractice/identifying-mitral-valve-prolapse-at-risk-for-ventricular-arrhythmia-and-sudden
4. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
5. https://pmc.ncbi.nlm.nih.gov/articles/PMC9683599/