What is the Holter Monitor test? 

The Holter monitor is a small medical device (about the size of a small camera) that is designed to record the activity of your heart (electrocardiogram or ECG) for 24-48 hours. This recording is done while you are going about your daily routine. The Holter monitor consists of a digital recorder and five to seven electrodes. The device operates on a battery and is portable.

The electrodes (small, sticky and plastic patches) are placed over certain areas of your abdomen and chest. They are connected to the machine with the help of wires. 

The machine records electrical impulses that coordinate with your heart contractions (which enable your heart to keep on circulating the blood properly). It gives information about the heart activity such as the rhythm of the heartbeat, how fast the heart is beating or the strength and timing of the impulses generated by the heart.

  1. Why is a Holter Monitor test done?
  2. Who cannot have a Holter Monitor test?
  3. How should I prepare for a Holter Monitor test?
  4. What is the procedure for a Holter Monitor test?
  5. How will a Holter Monitor test feel like?
  6. What do the results of the Holter Monitor test mean?
  7. What are the risks and benefits of the Holter Monitor test?
  8. What happens after the Holter Monitor test?
  9. What are the other tests that can be done with a Holter Monitor test?

Holter monitor test may be performed for several reasons:

  • To assess symptoms, such as tiredness, fatigue or dizziness, which could be related to the functioning of the heart
  • To evaluate the reason for chest pain that cannot be reproduced using exercise testing.
  • To evaluate the functioning of pacemaker in certain patients Read more: What is pacemaker surgery 
  • To check for irregular heartbeat or palpitations 
  • To determine the risk of any future heart-related conditions in case of already persisting heart conditions such as thickened heart walls, heart attack or Wolff–Parkinson–White syndrome (a cardiac condition which causes interference with the heart’s normal rhythm due to the presence of abnormal electrical pathways in the heart)
  • To determine the effectiveness of the treatment in case of complex arrhythmia (irregular heart rhythm)
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Holter monitor test is safe and has no risks associated with it. Hence, a Holter monitor test can be performed on most individuals.

During the test, adhesive patches will be placed on your skin and then connected to the recording device. Provide your doctor with a detailed list of medications that you are using.

Wear comfortable yet loose clothing with a high collar so that the device does not cause discomfort. Do not use a body lotion before or while you have the monitor on.

You do not need to fast before the test.

Holter monitor test is done in the following way:

  • Your doctor will ask you to remove any jewellery so that it does not interfere with the test results.
  • The doctor will give you a sheet or gown before asking you to remove the clothing from the waist up so that only the necessary skin is exposed where the electrodes can be attached.
  • He/she will clean your skin where the electrodes have to be placed. The hair over the skin area may also be removed or clipped if they are interfering with the electrodes.
  • The electrodes will be attached to your skin over the chest and abdomen. The Holter monitor device will be connected to the electrodes, and the doctor will ask you to wear the device either around your waist or over your shoulder like a bag. They may also clip it to a belt or pocket.
  • You must ask the doctor beforehand whether you may have to change the batteries of the device. 
  • After the installation of the device is complete, you will be asked to return to your normal activities and daily routine. Sometimes, the doctor may ask you to avoid doing certain activities if they want to monitor your heart activity under specific conditions.
  • Your doctor will instruct you to keep a diary in which you will mention all the activities that you are doing while being hooked up to the machine. 
  • The occurrence of any symptoms, such as chest pain, palpitations and dizziness, must also be mentioned carefully in the diary along with the date and time of activities. 
  • After the duration is complete, you will be asked to submit the monitor as well as the diary to the doctor.
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It may be slightly difficult to keep the electrodes attached to your skin as you continue doing your daily activities. Hence extra tape may be needed to keep the electrodes in place.

The test is painless. The monitor has to be kept close to your body always and therefore, may lead to a bit of trouble while sleeping.

While some changes in the heart activity may be attributed to the activities that you are performing, abnormal changing patterns can be indicative of arrhythmia and lack of oxygen to the heart.

Holter monitor test is a useful method for diagnosing abnormalities in the heart rhythm pattern. Apart from that, it is a non-invasive way for the doctor to determine if a particular treatment is working effectively or not.

Holter monitor test does not have any health risks associated with it. Some individuals may report mild skin irritation due to the attached electrodes. On rare occasions, the gel or paste used while attaching the electrodes to the skin may lead to an allergic reaction.

It may be slightly uncomfortable when the electrodes or tape is being removed. 

Certain factors can interfere with the test results. These are as follows:

  • Excessive sweating may cause the electrodes to loosen and fall off
  • Smoking or use of tobacco 
  • Proximity to magnets, high-voltage electric wires and microwave ovens 
  • The use of cell phones or MP3 players may also interfere with the signals. It is advised to keep these at a distance of at least 6 inches from the Holter monitor device
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There are no special measures that have to be taken after the test has been done. You may return to your daily activities and usual diet unless the doctor advises differently. 

Depending on your health status, your doctor may provide you with more instructions after the completion of the test.

Your doctor may ask you to undergo other tests to evaluate your heart functioning. These tests include the following:

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.


  1. American Heart Association [internet]. Dallas. Texas. U.S.A.; Holter Monitor
  2. John Hopkins All Children's Hospital [Internet]. Johns Hopkins Medicine. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System; Holter Monitor
  3. Genetics Home Reference [internet]. National Institute of Health: US National Library of Medicine. US Department of Health and Human Services; Wolff-Parkinson-White syndrome
  4. Instituto de Cardiologie De Montreal [Internet]. Montreal Heart Institute. Canada; Holter Monitor Test
  5. Olgin JE. Approach to the patient with suspected arrhythmia. In. Goldman Lee, Schafer Andrew I. eds. Goldman- Cecil Medicine. 25th ed. Philadelphia: PA- Elsevier Saunders ; 2016, chap 62.
  6. Miller JM, Tomaselli GF, Zipes Dp. Diagnosis of Cardiac arrhythmias. In: Douglas Zipes Peter Libby, Robert Bonow, Douglas Mann, Gordon Tomaselli eds. Braunwalds’ Heart Disease: A textbook of Cardiovascular medicine. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 35.
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