Ambulatory Electrocardiogram (Holter Monitor)

Purpose

The Holter monitor is a non-invasive portable system used to make a continuous digital recording of a patient’s heart rate and rhythm for 24 or 48 hours. This information may be required in order to detect any heart rhythm abnormalities, to adjust medications, or to match symptoms with heart activity.

Description

1. Seven small areas on the patient’s chest are prepared for the electrodes. This involves cleaning the skin with alcohol, marking the sites with a felt marker and rubbing the areas lightly with fine sandpaper. If necessary, Friar’s Balsam (compound benzoin tincture) may be used and the skin may be shaved for better electrode adhesion.
2. The wires are clipped onto the electrodes and an electrode is applied to each site. The wires are also secured to the electrodes by tape.
3. The wires and cable are connected to the Holter, which is then placed into a pouch and worn on a shoulder strap or belt.
4. The patient is instructed to press the Event button on the monitor and to record in the diary provided any symptoms experienced, including the time, circumstances, or activity associated with the symptom.
5. If the patient does not experience any symptoms during the monitoring period, he or she is instructed to return the diary with a note indicating "no symptoms."
6. A nurse will assist hospitalized patients unable to make diary entries with recording events and removing the device.
7. Outpatients are asked to remove the monitor at a specified time and to discard used as well as unused electrodes.
8. The equipment should be removed by hand ONLY. Scissors and other sharp tools should not be used to remove gauze or tape. Such tools should not be used near any parts of the equipment.
9. The equipment is to be placed in a clean bag and returned by the specified time.
10. The data is analyzed by a qualified technologist, the information reviewed by a cardiologist, and a report sent to the referring doctor within seven to 10 days of the monitor being returned. The referring doctor will inform the patient of the results.

Patient Instructions

Set up of the monitor will be done in the Cardiac Diagnostic Centre on H1 of the University of Ottawa Heart Institute. Patients should bring a list of all their medications to the appointment and arrive 15 minutes prior to the scheduled time.