Holter Monitoring

H O LT E R
MONITORING
BY: AYO-BUNDLE OYEWO

OMOTOLA
 In medicine a Holter monitor is a
type of ambulatory device a
portable device for cardiac
monitoring for at least 24 to 48
hours
INTRODUCTION

This Photo by Unknown author is licensed under CC BY.

 A Holter monitor is a small, wearable
device that records the rhythm. It is used to
detect or determine the risk of irregular
heartbeats (arrhythmias).
DEFINITION  A Holter monitor test may be done if a
traditional electrocardiogram (ECG OR
EKG) doesn’t provide enough
details about the heart condition.
W H Y H O LT E R M O N I T O R I N G I S
DONE ?
A health care provider may recommend Holter monitor if you have :

 Signs and symptoms of an irregular heart rhythm ( arrhythmia).
 Unexplained fainting.
 A heart condition that increases the risk of arrhythmias.

 To establish the link between palpitations
and abnormal heart rhythms
 To diagnose the cause of syncope or near syncope
 To evaluate transient episodes of cardiac arrhythmias

or myocardial ischemia
 Patients with neurologic events when transient atrial
fibrillation or flutter is suspected
 To monitor the efficacy and safety of pharmacological
I N D I C AT I O N S or nonpharmacological therapies
 To detect proarrhythmic responses to antiarrhythmic
therapy in patients at high risk
 To analyze the function of pacemakers or other
implantable devices
 To evaluate prognosis
 To stratify the risk of sudden cardiac death

C O N T R A I N D I C AT I O N S
 Mobile electrocardiograph monitoring is contraindication if it delays urgent
treatment, hospitalizations or a procedure. For example, it should not be part
of initial investigation for angina, where a stress would be more appropriate.
 The monitor is also contraindicated in patients who have syncope and high
risks factors at which time inpatient management is mandatory.
 Fixed rate peacemakers.
 Advanced or complicated pregnancy.
 Mental impairment leading to cooperate.
 A patient who refuses to undergo further therapy once arrhythmia is

established. Routine screening of asymptomatic patients.
 There are no significant risks involved in wearing a
Holter monitor. Some people have minor discomfort or
skin irritation where the sensors (electrodes) were
placed.
 Holter monitors aren't usually affected by other
electrical appliances. But some devices may interrupt
the signal from the electrodes to the Holter monitor. If
RISKS you have a Holter monitor, you should avoid the
following:
• Electric blankets
• Electric razors and toothbrushes
• Magnets
• Metal detectors
• Microwave ovens
 Wireless Holter Monitor
 Event Monitor
 Post events Recorders.

TYPES OF  Presymptoms Memory Loop Recorders
H O LT E R  Autodetect Recorders
MONITORS  Implantable Loop recorders
 Zio Monitor
 Physicians Ancillary systems

A Holter monitor is placed at a care provider's office during a
scheduled appointment. Unless your health care provider tells you
otherwise, plan to bathe before this appointment. Most monitors
can't be removed and must be kept dry once monitoring begins.
A care provider will place sensors (electrodes) on your chest.

These electrodes detect the heartbeat. They're about the size of a
silver dollar. If you have hair on your chest, some of it may be
shaved to make sure the electrodes stick.
HOW YOU
the size of a deck of cards.
P R E PA R E
Once your Holter monitor is fitted and you've received instructions

on how to wear it, you can leave your provider's office and return
to everyday activities.
lar. If you have hair on your chest, some of it may be shaved to

make sure the electrodes stick.
W H AT Y O U C A N E X P E C T ( D U R I N G )
 A Holter monitor is typically worn for 1 to 2 days. During that time, the
device records all of the heartbeats.
 Holter monitoring is painless and noninvasive. The sensors
(electrodes) and wires can be hidden under clothing. The device is
worn on a belt or attached to a strap.
 Don't take the Holter monitor off — it must be worn during the entire
recording period, even while sleeping.
 Water can damage a Holter monitor. Don't swim, shower
or bathe for the entire time you're wearing a Holter
monitor. If you have a wireless Holter monitor, you'll be
shown how to disconnect and reconnect the sensors
and the monitor so that you can shower or bathe.
 While you wear a Holter monitor, you can do most other
daily activities unless your provider tells you otherwise.
W H AT Y O U C A N You may be given a form to record your activities and
EXPECT any symptoms. It's particularly important to note if and
when you have any of the following symptoms:
(DURING) CONT
• Pounding, fluttering or skipped heartbeats
• Shortness of breath
• Chest pain
• Lightheadedness
 Once your monitoring period is over,
you will return the device to your health
care providers office. If you were asked
to keep record of symptoms that you
AFTER had while wearing the device , your
provider can compare the Holter's
monitor's data with your notes. This can
help your provider make accurate
diagnosis.
 Your care provider will review the Holter monitor
test results and discuss them with you.
Information from Holter monitor testing can tell
your provider if you have a heart condition and
if any heart medicines you currently take are or
aren't working.
 If you didn't have any irregular heart rhythms
while you wore the monitor, your provider may
R E S U LT S
recommend a wireless Holter monitor or an
event recorder, both of which can be worn
longer than a standard Holter monitor. Event
recorders are similar to Holter monitors and
generally require you to push a button when
you feel symptoms. There are several different
types of event recorders.
 The device stays in a pocket outside of the
body close to patients chest, usually in the form
of a neck sling or in the patient's vest pocket.
So theoretically there aren't any complications,
C O M P L I C AT I O
but the surface electrodes can irritate the
NS underlying skin and if left in place can cause
skin ulceration, but this rarely ever happens as
the device technicians remove them when they
take the machine off the patient.
CLINICAL
SIGNIFICANCE
 Utilization of the Holter monitor has significantly

increased, especially in the detection of occult
atrial fibrillation as a cause of a cryptogenic
stroke. Anticoagulation is always superior to
antiplatelet in the secondary prevention of stroke
due to atrial fibrillation. So, the diagnosis of occult
atrial fibrillation to initiate anticoagulation with the
help of the Holter monitor can prevent recurrent
strokes.
 Patients with LV systolic dysfunction and
presumed arrhythmic event as well as those with
symptoms supposed to be due to transient second
or third-degree heart blocks also form a significant
number of people who undergo the test
 The Holter monitor study is the most
widely used type of ambulatory
ECG monitoring. The test is quite
CONCLUSION good at diagnosing transient cardiac
arrhythmias that generally occur
during any given 24-48 hour period,
and is very safe.
THANK YOU!!!!

Holter Monitoring

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H O LT E R

BY: AYO-BUNDLE OYEWO

This Photo by Unknown author is licensed under CC BY.

A health care provider may recommend Holter monitor if you have :

 A heart condition that increases the risk of arrhythmias.

 To evaluate transient episodes of cardiac arrhythmias

 To stratify the risk of sudden cardiac death

 Advanced or complicated pregnancy.

 Mental impairment leading to cooperate.

 A patient who refuses to undergo further therapy once arrhythmia is

• Electric razors and toothbrushes

 Post events Recorders.

MONITORS  Implantable Loop recorders

 Physicians Ancillary systems

A care provider will place sensors (electrodes) on your chest.

Once your Holter monitor is fitted and you've received instructions

lar. If you have hair on your chest, some of it may be shaved to

 Utilization of the Holter monitor has significantly

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