Heart Rhythm Monitoring

Holtor Monitoring

What is a Holter monitor?

A Holter monitor is a small heart monitor that is worn for at least 24 hours and continuously records your heart rhythm.

What are the indications?

A Holter monitor is used to help diagnose heart arrhythmias and evaluate the cause of palpitations, lightheadedness and fainting. In patients known to have certain rhythm abnormalities such as atrial fibrillation we will use a Holter monitor to assess how well our medication is controlling the heart rate.

How is it done?

You are usually hooked up to the Holter monitor before you leave the office, Emergency Care department or hospital. We will clean your chest with alcohol and apply a special adhesive to make the electrode patches stick. If you are a male patient, we may have to shave 2-3 areas on your chest to ensure that the patches will remain intact. Three to five electrodes or EKG patches will be stuck to your chest and the monitor leads will be attached to them. The monitor may be worn in a pouch around your neck or it can clip to your belt.

You will be given a diary to record your activity or any symptoms you experience during the monitoring period. It is very important that you fill this out and bring it back to our office when you return the Holter monitor. This will allow the physician to correlate your symptoms with the monitor readings provided and help make an accurate diagnosis.

How do you prepare for it?

It is important to shower before the Holter monitor is attached to your chest. You will not be able to remove the electrodes for 24 hours while wearing the monitor. This allows us to receive the most accurate information regarding your heart rhythm.

Our staff will show you how to replace an electrode or patch if it becomes loose or falls off. Please alert our staff if you are allergic to adhesives—we can provide nonallergic patches to wear during your test.

What are the risks?

There is no meaningful risk associated with this test. As noted above, some persons exhibit skin sensitivity to the adhesive on the EKG patches.

Event Monitoring

Event monitors are used to record heart rate and rhythms for brief periods. They help doctors diagnose problems that don’t happen often enough for an EKG or Holter monitor to record. The monitor may be worn up to 30 days.

Event monitors work only when a person turns on the device. When you experience symptoms, you activate the device and make a recording of your heart’s electrical activity. Because there are different models of event monitors, they can be worn like a wristwatch, carried in your purse or pocket, or worn like a beeper.

Implantable Loop Recorder (ILR)

The implantable loop recorder (ILR) is a subcutaneous, single-lead, electrocardiographic (ECG) monitoring device used for diagnosis in patients with recurrent unexplained episodes of palpitations or syncope. The device is typically implanted in the left parasternal region and is capable of storing ECG data automatically in response to preset parameters (including significant bradyarrhythmias, tachyarrhythmias, or pauses) or patient activation. It is particularly useful either when symptoms are infrequent or when the burden of certain arrhythmias needs to be assessed. It is a very simple outpatient procedure which only takes minutes, but could provide long-term data up to three years.