Daily Holter ECG monitoring: indications, technique

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Daily monitoring of ECG or as it is called by author Norman Holter, Holter monitoring, is a sufficiently informative test of the cardiovascular system. The bottom line is the study of the heart condition in the daily activity of subjects. In contrast to conventional electrocardiography, with daily monitoring, ECG recording continuously for a certain time.

The content of the article

  • The main difference from electrocardiography
  • Possibilities Holter ECG monitoring
  • The main indications for Holter monitoring
  • The methodology of monitoring heart halter
  • The rules of conduct or what you need to know the patient
  • The deciphering and interpretation of data
  • Recommended video on the topic: “Holter EKG”

Holter study is especially important in patients with complaints of periodic episodes of pain in the heart area or the occurrence of shortness of breath. Very often there are situations in which these symptoms bother you from time to time under certain circumstances. This happens when you physical exertion or during emotional stress, stress.

The main difference from Conventional electrocardiography electrocardiography provides detailed information about cardiac activity. In particular, the ECG you can see the rhythm of the contractions, circulatory insufficiency (ischemia) and the functional state of cardiac conduction system. However, such a study allows us to estimate the above mentioned parameters only “in the moment”, i.e. at rest in terms of the doctor’s office in removing the ECG.

At Holter monitoring there is an opportunity to examine the state of cardiovascular system under different conditions of life. Correctly executed the procedure allows the doctor to detect some arrhythmias and transient (non-permanent) moments ischemia that occurs under certain circumstances. A comparison of the complaints of the patient, the ECG pattern at the time of the onset of symptoms and a description of what was the subject at this moment, can give a complete picture of physiological cardiac problems.

In simple terms, electrocardiography is a “slice” of the heart for a few seconds – minutes. But for a daily, Holter monitoring, this “fragment” has a fairly long period (usually 24 hours).

Possibilities Holter ECG monitoring

It looks like the device itself — a Holter monitor Modern daily monitoring allows you to:

  • To determine the heart’s activity in terms of daily activity (in a state of normal or increased physical and/or emotional stress).
  • To identify the condition and conductivity of the heart during sleep, the occurrence of arrhythmias.
  • To clarify the suggested causes are unconscious States.
  • To study not only the kind of arrhythmias, but the number of episodes of arrhythmia for some time. The possibility appears to determine the severity of the violation and duration of stay of the patient in such conditions.
  • To determine at what level the cardiac conduction system violations of its work.
  • To identify cases of myocardial ischemia (heart muscle). The important point is the possibility of determining painless cases of eating disorders the heart.
  • Indirectly to judge about the cause of the pain is behind the breastbone and their danger to humans (compare the fact of occurrence of pain with the state of the ECG at the moment).
  • To determine the relationship of disorders of the heart with vascular spasm and blood pressure level.

Thus, Holter monitoring may increase the effectiveness of treatment by determining the functional state of the cardiovascular system on a background of reception of preparations.The main indications for Holter monitoring

For the detection of arrhythmias:

  • The occurrence of syncope of unknown cause.
  • Feeling disruptions of the heart.
  • The appearance of ECG changes, indicating the presence of arrhythmias.

For the determination of circulatory disorders of the heart (ischemia):

  • The atypical and typical angina pain in the chest and left shoulder blade.
  • Attacks of shortness of breath. Especially when their relationship to stress or increased physical exertion.
  • Frequent increase in blood pressure (for diagnosis of vasospastic angina (lack of blood heart as a result of spasm of the coronary (heart) vessels)).

For monitoring treatment:

  • Evaluation of frequency of occurrence of arrhythmias.
  • To study the frequency of ischemic attacks.
  • Determination of correct operation of the pacemaker.

Preventive indications:

  • After a myocardial infarction.
  • In case of violation of contractile function of the heart.
  • The presence of congenital and acquired heart disease.
  • Chronic circulatory failure II and III stage.
  • High blood pressure.
  • Before surgical operations.

Absolute contraindications to daily monitoring no.

The methodology of monitoring heart halter

When conducting daily monitoring apparatus, which records ECG, attaches to a belt or chest with a special tape or belt. It is a small box smaller than a smartphone, linking the wires to the electrodes. The latter with a patch glued on the chest at certain points. Thus, during the day there is a continuous check and record data about the activity of the heart in device memory. In the process of monitoring the patient leads a normal life rhythm, not changing the regime.

The rules of conduct or what you need to know the patient


  • You should avoid strenuous activities that cause excessive sweating, because the chest can come off the patches with electrodes.
  • You cannot take a bath or shower.
  • Not be located near power lines and microwave ovens!
  • You need to keep a detailed diary, where it is important periodically to record their activity and mood.


The deciphering and interpretation of data

After the inspection apparatus is removed from the patient and connected to the computer. Doctor of functional diagnostic studies the electrocardiogram taken during the day. In case of any deviations from the norm, the specialist records the time of their appearances and matches with the patient diary, which describes the sensation of the tested and the activity at that time.

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