Holter Monitoring Menu

What Is Holter Monitoring?

Ambulatory Cardiac Monitoring

Holter monitoring is considered one of the types of longer-duration ambulatory monitoring as compared with the brief 10-second snapshots an electrocardiogram (ECG) provides. As such, recordings can continue uninterrupted for 24-48 hours. This on-going monitoring has two American Heart Association-sanctioned indications:

  • Transient, unexplained palpitations
  • Mysterious episodes of dizziness, passing out (syncope), or near-syncope

Aside from these official indications, vascular specialists also find it useful for the following:

  • To assess the efficacy of treatment in patients with atrial fibrillation (AF) and observe for covert episodes of it
  • To monitor cardiomyopathy patients (ventricular hypertrophy, congenital heart disease, etc.)
  • For close surveillance of patients who had recently experienced acute coronary syndrome (ACS)
  • To identify “silent” myocardial ischemia

Holter Monitor

The Holter monitor consists of an array of 3 external electrodes connected to a shoulder strap-carried monitor. The monitor is small enough to allow going about day-to-day tasks, which offers the advantage of identifying events that would ordinarily go hidden or unprovoked by bedrest or the sedentary non-activity other more cumbersome arrangements (e.g., 12-lead ECG) would create. The monitor is returned to the physician’s office for review of the data recorded during the 24-48 hours it was being collected.

Other Cardiac Monitors

When Holter monitoring indicates the need for continuous monitoring or when the 24-48 hours of data fail to identify on-going, intermittent complaints, longer monitoring is effected by implantable (under the skin) loop recorders, about the size of a small thumb drive, which can wirelessly stream the day’s data to the physician over the Internet every evening during sleep. Alternately, a small patch–the Zio patch–can be used. These small devices do not render the data a 3-lead Holter monitor can, but are suitable for continuous, unobtrusive cardiac surveillance; even with their limitations, they can provide helpful–even crucial–data.

Many normal fluctuations in cardiac activity can occur as a result of vagal stimulation, athleticism, medication side effects, or orthostatic- or respiratory-mediated blood pressure changes, and the continuous monitoring provided by Holter monitors and other devices can separate these normal variations from true cardiac pathology.


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This information is provided by Vascular Health Clinics and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.

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