Why would I need a Holter monitor test?
Charles H. Machell, MD
Clinical Cardiac Electrophysiology
A holter monitor is used to identify the presence of an arrhythmia. Charles Machell, MD, with Methodist Texsan Hospital explains the history of a holter monitor and how it helped understand an irregular heart beat.
Ronald L. Walsh, DO
Cardiology (Cardiovascular Disease)
A Holter monitor test is used when someone has symptoms of heart arrhythmia. In this video, Ronald Walsh, DO, of Largo Medical Center, describes the Holter monitor, a 24-48 hour ambulatory ECG monitoring device. 
Andrea C. Bryan, MD
Cardiology (Cardiovascular Disease)
You may need a Holter monitor test if you have symptoms such as fainting, periods of dizziness, or if you feel your heart pounding, racing, or beating unevenly. This test will give your physician a beat-by-beat record of your heart’s rhythm. By comparing your diary and Holter recording, your doctor can diagnose heart rhythm problems that may be causing your symptoms.

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The Holter monitor is a type of electrocardiogram (ECG or EKG) used to monitor the ECG tracing continuously for a period of 24 hours or longer. A standard or "resting" ECG is one of the simplest and fastest procedures used to evaluate the heart.

When symptoms such as dizziness, fainting, low blood pressure, prolonged fatigue, and palpitations continue to occur without a definitive diagnosis obtained with a resting ECG, your physician may request an ECG tracing to be run over a long period of time, using the Holter monitor.

Certain dysrhythmias/arrhythmias (abnormal heart rhythms), which can cause the symptoms noted above, may occur only intermittently, or may occur only under certain conditions, such as stress. Dysrhythmias of this type are difficult to obtain on an ECG tracing that only runs for a few minutes. Thus, the physician will request a Holter monitor to allow a better opportunity to capture any abnormal beats or rhythms that may be causing the symptoms. The Holter monitor records continuously for the entire period of 24 to 48 hours. Some Holter monitors may record continuously but also have an event monitor feature that you activate when symptoms begin to occur.
In order to detect atrial fibrillation -- a heart rhythm abnormality that comes and goes -- continuous monitoring of the heart is required. The doctor may ask that you wear a Holter monitor, a portable device that records your heart rhythm over time, while you go about your daily activities and even while you sleep. Holter monitoring for 24 hours or longer may be needed.
Your doctor might recommend a Holter monitor test if you faint, have periods of dizziness, or if you sometimes feel your heart pounding, racing, or beating unevenly.

A Holter monitor test gives your doctor a beat-by-beat record of your heart’s rhythm for a long period of time. Comparing your diary to the Holter recording will help your doctor diagnose heart rhythm problems that may be causing your symptoms.
Holter monitoring is usually used to solve a medical mystery. For example, you may be experiencing heart palpitations (an irregular heart rhythm), but nothing abnormal shows up on a standard electrocardiogram (ECG). A Holter monitor can provide more clues for your doctor to use in solving the mystery.

A standard ECG records the electrical activity of your heart for only a few seconds. By comparison, you wear a Holter monitor for 24 to 48 hours. And unlike an ECG, you do not rest quietly during Holter monitoring. Instead you go about your daily activities while being continuously monitored. You also keep a diary of your activities and any symptoms.

As a result, an abnormality that comes and goes, or occurs only during certain activities or certain times of the day, is more likely to be detected by the Holter monitor.

The most common reasons for getting a Holter monitor test are:
  • Unexplained fainting or dizziness
  • Palpitations, or a feeling that your heart is fluttering or beating too hard or too fast
If you have already been diagnosed with a heart problem, your doctor may use the Holter monitor to gauge how well your therapy is working. Similarly, if you have a heart condition that makes you more prone to developing a rhythm abnormality, your doctor may use a Holter monitor to detect the arrhythmia.

Continue Learning about Arrhythmia

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.