Cardiac Holter (testing tests)



The cardiac holter or complete dynamic electrocardiogram according to Holter it is a non-invasive and painless investigation that uses the same principle of the electrocardiogram (ECG) and, through a series of electrodes, connected to a portable battery-powered electrocardiograph, allows to record the electrical activity of the heart for 24-48 hours .

The examination may be requested by the doctor when the person reports having palpitations, fainting, chest pain or difficulty in breathing (dyspnea) and the electrocardiogram does not detect any abnormalities.

The cardiac holter is an important diagnostic test in the study of arrhythmias, or to identify all those alterations in the heart rhythm with sporadic and discontinuous appearance, and disorders (symptoms) such as heartbeat, dizziness, loss of consciousness. It is also useful in the case of a reduced blood supply to the heart (ischemia) or chest pain to be ascertained.

The exam also allows you to evaluate the effectiveness of a drug treatment or the operation of previously implanted devices (pacemakers, cardioverter defibrillators).

The heart rhythm can also be monitored for a period longer than 48 hours up to five to seven days by taking advantage of the life capacity of modern batteries.

The exam

Cardiac holter is performed through a device that records the electrical activity of the heart for at least 24 hours.The person who has to undergo it must go to a cardiology clinic (hospitalization is not necessary) where some electrodes (usually 6 to 8) connected to a portable device (a small battery-operated recorder) will be applied to the chest ) which will record the electrical signals.

The device, the size of a mobile phone, is fastened to the belt or placed inside a pocket; and must remain connected even at night to continuously record the activity of the heart. During the recording hours it is important to continue to perform normal daily activities (working, eating, sleeping, walking, etc.). It is also important to note in a diary (clinical diary) the time and the various activities carried out during the day, as well as the appearance of any disturbances, so that each event reported in the diary can be related to the data recorded by the device. . The devices currently in use provide for the presence of a button to be activated in the event of chest pains or other significant discomfort. A signal is thus recorded which constitutes a point of reference during the reading of the trace by the doctor.

Once recorded, the data is read by the cardiologist who evaluates them by comparing the recording with the notes on the activities carried out and delivers the result (report) to the patient to be delivered to his / her doctor and, if necessary, prescribes further tests or the most appropriate treatment .

The examination is painless. It is advisable to wear comfortable clothes that are easy to take off and put back on; while being able to carry out all the daily activities, it is necessary to make sure that the electrodes do not detach from the skin due to excessive movements.

The equipment (electrodes and device) must not be wet and, consequently, it will not be possible to shower while wearing the Holter; therefore it is a good idea to wash before the exam so that there is no need in the following hours.

The device is programmed to record data throughout the defined period (24-48-72 hours, 5 or 7 days). At the end, it is removed and returned to the cardiology clinic.


The results of the cardiac holter are similar to those of an electrocardiogram (ECG), with the advantage that the function of the heart is recorded and evaluated for a much longer period than the conventional ECG, not in a doctor's office but in one's home and / or in the usual working environment.

Based on the results obtained, the doctor has a more precise picture of the presence of any disorders and decides whether or not to prescribe other tests. If the result confirms the presence of abnormal cardiac activity, the doctor may, for example, recommend repeating the monitoring periodically or prescribe adequate therapy.


Royal Brompton & Harefield NHS Fundation Trust. ECG Holter monitor (English)

Humanitas Gavazzeni. Cardiac Holter

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