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Holter Monitoring

What is Holter Monitoring?

Holter monitoring involves a portable device that allows a continuous ECG to be taken. An ECG measures the heart’s electrical activity, including the time it takes for the signal to travel between the different areas of the heart, as well as its strength. A traditional ECG measures the heart’s rhythm in just a few seconds, but Holter monitoring measures the heart’s activity for an extended period of time, typically between 24 and 48 hours.

Why is Holter Monitoring Done?

A Holter monitor may be needed if problems with the heart’s activity are irregular and may be missed by a traditional ECG. In many cases, patients report symptoms that come and go, and an ECG may not record the heart long enough to catch irregularities. The Holter monitor allows a more extensive report of the heart’s activity and any changes that occur during daily activity and rest. This gives Dr. Beshai a better idea of what could be triggering symptoms. 

When is Holter Monitoring Needed?

Dr. Beshai may recommend a Holter monitor if you experience abnormal heart rhythms or cardiac symptoms that come and go including:

  • Racing heart
  • Dizziness or fainting
  • Sensation of the heart skipping a beat
Holter monitoring can be used as a diagnostic test and can also help record how well medication or other treatments are working to regulate the heartbeat.

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How is Holter Monitoring Performed?

To begin your Holter monitoring process, several electrodes will be placed on the chest. If you have a hairy chest, this area might be shaved to ensure firm attachment. These electrodes will measure several different areas of the heart. Once all electrodes are firmly in place, your Holter monitor will be explained. The Holter monitor is a battery-operated device, about the size of a small camera. You will be asked to keep the device in your pocket, attached to the waist, or across your shoulders.

Once you have been set up with your Holter monitor, you are encouraged to go about your regular activities for the next 24-48 hours. However, you will need to avoid bathing, showering, or swimming while the monitor is in place. Besides wearing the Holter monitor, you will also be asked to record your activity and your symptoms. Keeping a log of your symptoms and when they happen is an essential part of the process and will help Dr. Beshai understand your condition. 

What are the Next Steps After Holter Monitoring?

After your Holter monitoring period is over, you will return to Dr. Beshai and your heart activity record will be processed. You will also hand in your symptoms log which Dr. Beshai will review closely and compare with your ECG record. The results of your Holter monitoring test will typically be ready in one to two weeks. Depending on the results, Dr. Beshai may recommend additional testing or he may have enough information to begin developing your treatment plan to manage your symptoms.   

Schedule Your Holter Monitoring Appointment

Dr. Beshai uses ECG and Holter monitoring as an important diagnostic test that can detect abnormalities in the heart rhythm and where they’re coming from. When it comes to the heart, early screening and monitoring are essential, even if symptoms have not occurred yet. If you think you could benefit from Holter monitoring, contact Heart Rhythm Institute of Arizona to meet with Dr. Beshai, an experienced cardiac electrophysiologist, by calling our office or filling out our online form. 

Are Holter monitors covered by insurance?

When recommended by Dr. Beshai to gather more information about your heart rhythm, authorization will be submitted to your insurance company. Yes, this is a covered diagnostic.

Can a heart monitor detect anxiety?

A Holter monitor is designed to detect irregular heartbeats, which may or may not be caused by anxiety. Alternatively, many abnormal heart beats do result in patient concern and can trigger anxiety like symptoms. A clinical diagnosis of general anxiety disorder can only be confirmed by a psychologist or psychiatrist.

Can a Holter monitor detect AFib?

Yes, a Holter monitor can detect many types of irregular heartbeat including atrial fibrillation.

Can a Holter monitor detect shortness of breath?

Episodes of shortness of breath often affect or are affected by an irregular heartbeat. A Holter monitor will record any such irregularities.

Can a Holter monitor detect sleep apnea?

Holter monitors may detect slow heart beats, atrial fibrillation or even episodes where the heart may stop during sleep. These findings could be suggestive of underlying sleep apnea and may prompt a referral to a sleep medicine specialist.

Can I exercise while wearing a Holter monitor?

Dr. Beshai will instruct you on what activities you should avoid, which may include strenuous exercise to ensure your safety and health prior to a final diagnosis.

Can you shower with a heart monitor?

No, the Holter monitor cannot get wet and will need to be removed when bathing, showering or swimming.

Do you sleep with a heart monitor?

Yes, you will need to wear the Holter monitor for the entirety of the monitoring period

Does Medicare pay for a Holter monitor?

Yes, Medicare does cover and pay for Holter monitoring.

How long do Holter monitor results take?

Results are typically available within 3-5 days.

How long do people wear heart monitors?

Holter monitors are typically worn for 3-15 days.

What are some of the indications for ordering a Holter monitor test?

Holter monitors are indicated in patients who are experiencing symptoms that could be attributed to an irregular, fast or slow heart beat.

What are the different types of heart monitors?

There different types of monitors. Some come in the form of a patch that sticks to your chest. There are other types that have 3 wires that stick to chest and connect wirelessly to a device worn on your waist.

What is the difference between a Holter monitor and an event monitor?

A Holter monitor is a continuous monitoring device. An event recorder is a type of monitor that the patient is able to save an record events for which they are having symptoms or events. The event recorder also will detect any arrhythmia events that you may not have been feeling.

Who needs a Holter monitor?

Patients who are experiencing shortness of breath, dizziness, palpitations or passing out spells. It is important to rule out any abnormally slow, fast, or irregular heart beats as the cause of the symptoms.

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John F. Beshai, MD
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Dr. Beshai is a board-certified electrophysiologist internationally renowned and respected for his expertise and research. Having published in major medical journals and travelled all over the world to present research, he is dedicated to providing innovative, state-of-the-art care to his patients.