Holter monitoring is a non-invasive diagnostic test that continuously records heart rhythm over 24 hours or longer as patients go about their daily activities. This extended ECG recording captures arrhythmias that might not be evident during a brief office ECG. At Livasa Hospital, Holter monitoring is utilised for diagnosis of suspected arrhythmias, assessment of symptom severity and evaluation of treatment efficacy.

Understanding Holter Monitoring

Holter monitoring involves a small, portable device worn on the body that continuously records the heart's electrical activity through electrodes placed on the chest. Modern digital Holter monitors are lightweight and unobtrusive, allowing patients to maintain normal activities throughout the monitoring period.

Clinical Indications for Holter Monitoring

Holter monitoring is recommended for:

• Palpitations – Evaluation of awareness of irregular heartbeats

• Syncope or presyncope – Investigation of arrhythmias as cause

• Dizziness – Assessment of rate or rhythm abnormalities

• Diagnosed arrhythmia assessment – Severity and frequency documentation

• Treatment efficacy evaluation – Whether medication controls arrhythmia

• Sudden cardiac death risk assessment – Identification of dangerous rhythms

• Post-procedure monitoring – After ablation or device implantation

The Holter Monitoring Procedure

The monitoring process is straightforward:

1. Small electrodes are attached to the chest wall with adhesive pads

2. Leads from the electrodes connect to a portable recorder

3. The recorder is secured to the body using a strap or pouch

4. Patient returns home and maintains a diary of symptoms and activities

5. At the same time the next day, the device is returned

6. Data is downloaded and analysed by cardiologists

No activity restrictions; patients maintain normal lifestyle during monitoring.

Data Analysis and Reporting

Holter analysis quantifies:

• Heart rate – Minimum, maximum and average heart rates

• Rhythm – Normal sinus rhythm versus arrhythmias present

• Ectopy – Frequency of premature beats (atrial and ventricular)

• Arrhythmia episodes – Frequency, duration and haemodynamic significance

• Pauses – Any significant RR intervals >2 seconds

• ST-segment changes – Evidence of ischaemia

• Heart rate variability – Autonomic function assessment

Common Findings and Their Significance

Benign findings:

• Isolated premature beats (common, usually benign)

• Sinus arrhythmia (normal variation with breathing)

• Ectopic rhythms not associated with symptoms

Concerning findings:

• Frequent runs of ventricular tachycardia

• Significant bradycardia with symptoms

• Pauses >3 seconds

• High-grade AV block

• Atrial fibrillation (new onset)

Symptom Correlation

Critical to interpretation is correlation with the patient's symptom diary:

• Symptoms occurring with normal rhythm are unlikely arrhythmia-related

• Arrhythmias occurring without symptoms may be benign

• Correlation strengthens diagnostic confidence

Advantages of Holter Monitoring

• Non-invasive, no radiation exposure

• Records rhythm during normal daily activities

• Captures infrequent or paroxysmal arrhythmias

• Relatively inexpensive

• Provides 24-hour trend data

Limitations

• Cannot capture very infrequent events (occurs once per week or month)

• Limited to 24–48 hours

• Electrodes may cause skin irritation

• Some patients uncomfortable wearing device

Extended Monitoring Alternatives

For less frequent arrhythmias:

• Event recorders – Patient-activated recording of symptoms

• Implantable loop recorders – Permanently implanted monitoring device

• Mobile cardiac telemetry – Wireless 24-hour monitoring with live transmission

Why Choose Livasa Hospital?

• Experienced cardiologists interpreting all Holter studies

• State-of-the-art digital recording equipment

• Rapid turnaround for result reporting

• Integration with arrhythmia management services

NAP – Contact Details

Livasa Hospital Mohali
Sector 71, Sahibzada Ajit Singh Nagar (SAS Nagar)
Mohali, Punjab – 160071
Phone: +91-80788 80788 (24/7 Emergency)
Website: www.livasahospitals.com

Call +91-80788 80788 to arrange Holter monitoring at Livasa Hospital.