HOLTER

Indications

• documenting symptomatic & asymptomatic arrhythmias in relationship to daily activities
  • arrhythmia should occur at least daily*
• assessing the ventricular response to atrial fibrillation
• assessing pacemaker function
• confirming episodes of myocardial ischemia, not associated with angina pectoris

* use event recorder if symptomatic arrhythmia occurs less frequently than daily

Adverse effects

• device limits patient activities

Procedure

• continuous monitoring of the electrocardiogram is conducted for a 24-48 hour period (generally 24 hours)
• patient log allows correlation with symptoms

Interpretation

Highly probable pathologic rhythms:

• sustained ventricular tachycardia
• 2nd or 3rd degree heart block
• prolonged pauses of > 3 seconds

Possibly pathologic rhythms:

• brief runs of atrial fibrillation
• supraventricular tachycardia
• non-sustained ventricular tachycardia
• frequent in elderly without syncope or presyncope
• significant if symptoms accompany dysrhythmia

More general terms

• ambulatory arrhythmia monitoring

Additional terms

• electrocardiogram (ECG, EKG)
• event monitoring (event recording, loop recording, Zio patch)