Holter Montior

What is a Holter monitor?

A Holter monitor (often simply "Holter" or ambulatory electrocardiography "EKG / ECG" device) is a portable device for continuously monitoring various electrical activity of the cardiovascular system for 1 to 2 days

A Extended Patch Holter Monitor is a devcie that has no wires and attaches via a patch to the center of the chest.  It may be worn from 3-14 days.  This records every beat for the entire time it is worn but does NOT send any information.  All information is only available after you bring it back.  Please be aware that only select insurance companies will cover this monitor.

It is useful for evaluating for cardiac arrhythmias which occur daily or every other day.

For patients having more rare symptoms, a cardiac event monitor, which can be worn for a month can be used.

When might this be ordered?

If your child has a previously identified rhythm abnormality or ectopy (extra beats) on a prior study.  

If your child has complaints of chest pain, palpitations, fainting or dizziness that are frequent.  

What is expected on the day of my Holter?

There will be a $50 deposit (regardless of your insurance) that can be given by cash, check or credit card.  The deposit will NOT be processed unless the Holter is not returned on time or is damaged.  

Your child must be accompanied by a parent / guardian unless they are over 18 years old.  Otherwise we will have to reschedule.

Please make sure we have an correct phone number on file as we will be calling to provide results. 

What is involved in a Holter monitor?

For a 1 to 2 day Holter we will apply 5 small stickers to the chest which are connected to wires running to a small box that can be clipped to clothing or placed in a bag worn around the neck. 

There is a button on the device that is to be pressed for any symptoms, at bedtime or during exercise.  

You will be provided a diary to document when the button was pushed and for what reason.  We must have this returned with the device in order to fully evaluate your child.  

You will be asked to keep the monitor on until you bring it back including during sleep, school and daily activities. 

For the 3-7 day Extended Patch Holter Monitor it is one patch with a small device that is placed on the center of the chest. 

What precautions should I take while wearing the monitor?

The 1 to 2 day monitor CANNOT get wet.  You should not shower, bathe or swim while wearing it.  You should not apply any lotions or powders while wearing it, deodarant is okay.  Ideally you should try to shower before having it applied.  

You should try to avoid any activies where you expect the monitor could be damaged, such as contact sports or vigorous play.  

You should try to do your normal activities since we are trying to get an idea of your rhythm during an average day. 

If a lead becomes disconnected you should reattach it as soon as it is noticed.  The picture at the bottom of this page will help you know where each lead color belongs. 

Do NOT pull wires, they should always be unattached from the stickers directly to avoid damage.  

For the Extended Holter Patch Monitor this device since it has no wires can get splashed on (such as in a shower) but CANNOT go underwater.

When should I expect results?

Results may take up to 1-2 weeks from the day you return the monitor.  Unfortunately due to a high volume of patients we may not get back to you in that time.  If you have not heard any results after 2 weeks we ask you call our office to check on your results.   We will always try to reach out to you immediately to give results if something abnormal is found.  

You should expect a Telephone visit to go over results of your monitor. 

What if the Holter is damaged or late?

We should always ask that you inspect the device before we place it on your child to note any scracthes or damage.  You will be asked to sign a Holter Agreement that the device was received by you undamaged and working (or you can document any scratches you see).   If it is returned damaged the cost could be from $40 to $2000 depending on what part is damaged.  

Because are monitors are in high use and we only have a limited supply returning them on time is important.  Failure to return them on time may result in another patient not being able to have their test done.

You will be asked to sign a Holter Agreement prior to placing the device which will indicate when the device is due to be returned.  If it is late your $50 deposit will be kept and you will be charged $50 a day until it is returned.  If it is not returned you will also be charged the full price to replace the monitor which may be up to $2000 in addition to later charges.  If you are going to be only slightly late in returning the monitor we ask you call us that day to let us know.  

For our 1 to 2 day Holter monitors we CANNOT have them mailed, they must be brought back to our office.  Any adult may bring this monitor back but we will be inspecting for damages at the return.  


Guide to lead placement