What is HOLTER MONITORING?

A holter monitor is a continuous recording of your heart rhythm, usually for 24 hours.

What is the purpose of a Holter monitor?

A holter monitor records the function of your heart while you are going about your usual daily activities. A holter monitor can detect problems that occur with your heart. A holter monitor is especially valuable in detecting heart problems that occur intermittently and thus, may not be present when you are seen in your physician's office. Typically, a holter monitor is useful in the following situations:

• if you have spells of dizziness or chest palpitations, a holter monitor can detect any associated heart rhythm disturbances.
• if you have chest pain, fatigue or shortness of breath, a holter monitor may help determine if your heart is receiving an adequate amount of blood.
• if you have a pacemaker, a holter monitor can determine if your pacemaker is functioning properly.
• if you have had a heart attack or open heart surgery, a holter monitor can be used to assess the current functioning of the heart.
• if you are taking certain medications to treat a rhythm problem with your heart, a holter monitor can assess the effectiveness of these medications.

How do you get a holter monitor?

This test must be ordered by your physician. The monitor is applied by trained technicians in the privacy of an examination room at Dubuque Internal Medicine. If a friend or relative has accompanied you, we ask that they wait in our waiting room. The entire process of hooking you up to the holter monitor should not take more than 30 minutes.

Seven electrodes (patches) are placed on your chest (see illustration) and connected to leads (called monitoring wires) which are in turn, connected to the recording device. All the information collected is stored on a computer disc inside the recording apparatus. The recording device can be worn around your waist or over your shoulder using a strap. Excessive chest hair may need to be shaved off in order to assure that the electrodes remain in place on your chest.

7 electrodes: proper locations designated by dots

When does the test begin?

Once the electrodes, wires and recording device are all connected, the technician will test the equipment to make sure everything is working properly. After this test run, the recording begins immediately. You will be asked to return to Dubuque Internal Medicine in 24 hours. Please try to wear the monitor the entire 24 hours so that we get the maximum amount of information from this test.

What do you need to do DURING the test?

The most important task for you is to record information in a diary. You should include the following information in your diary:

• any symptoms you experience while wearing the monitor, including fatigue, shortness of breath, dizziness, chest pain, palpitations, weakness or numbness.
• any physical activity you do while wearing the monitor (for example, whenever you are running, walking, doing aerobics or climbing stairs, please record the times when you started and finished these activities in your diary)
• record your meal times
• record any stressful events (including things like getting stuck in traffic or irritations with your family)

In addition, you should try to perform your usual activities while wearing the monitor. Don't limit your activities simply because you are wearing the holter monitor. If you aware of certain activities that bring about your symptoms (that is, the symptom(s) that prompted your physician to order a holter monitor), please make sure you perform these activities while you are wearing the holter monitor. If your symptoms do not occur, try repeating the activity several times.

Also, if symptoms do occur while you are wearing the holter monitor, make sure to press the event button on the recorder so that time is marked on the computer disc.

Restrictions while you are wearing the holter monitor.

Avoid bathing, showering and swimming. The recording device should not get wet. Also, you should not use an electric blanket, electric shaver, a heating device for a waterbed or any electromagnetic equipment as all these things interfere with the ability of the computer disc to store information. For similar reasons, don't have an X-ray taken while you are wearing the holter monitor.

Please check your electrodes periodically to make sure they are not loose or have fallen off. If an electrode falls off, replace it as soon as possible with an extra patch (you should have received a few extra patches when your holter monitor was originally hooked up) and snap the electrode wire back on to the patch. Also, make a note in your diary that you had to replace an electrode patch. Be especially careful while you are changing clothes as electrodes may fall off at this time.

How is the test discontinued?

After 24 hours, you need to return to Dubuque Internal Medicine to have the holter monitor removed. This process takes about 15 minutes.

If you have any questions during the

24 hours while you are wearing the monitor, please call 563-557-9111 at any time of the day or night.

When will I find out the results?

The information recorded is analyzed by a computer and your physician. You will be notified of the results within one week of the test. If you have not heard about the results by one week, please call the office at 563-557-9111.

Does insurance cover this test?

Some insurance companies pay for this test and some only pay for this test if you have a certain diagnosis. You need to check directly with your insurance carrier to determine if you have coverage for this procedure.