How to prepare for a Holter monitoring test?

How to prepare for a Holter monitoring test?

Holter monitoring is 24-48 hour recording of the ECG using small electrodes attached to the chest. It is an important test to assess heart rhythm disorders. The electrodes are attached to the chest and they contain a gel to improve electrical conduction. Chest areas should be clean and dry after a bath. If there is a lot of hair on the chest, regions where the electrode patches are attached will have to be shaved. Otherwise the patches will not stick well. It may be better to shave the whole chest area for better results. Remember that they have to be firmly in place through out the recording.

The Holter monitor has to be worn continuously for the period advised by the health care provider. The recorder can be worn on the belt or any other convenient location. Since it is a small device, the recorder and wires can go inside a loose dress. As water can damage the recorder, do not swim, shower or bathe while you are wearing the Holter monitor. Almost all other routine daily activities can be undertaken while the monitoring is going on.

A diary of activities and symptoms like irregular heart beats, shortness of breath, chest pain and light headedness has to be kept and returned to the Holter room after the recording. The technician will show you how to press the event marker button on the Holter recorder when you have a symptom. Pressing the event marker will help correlation of symptoms with ECG record, along with the event diary.

The number of electrode patches applied over the chest will depend on whether it is a two channel or three channel Holter recorder. Colour coding of the electrodes may also vary from manufacturer to manufacturer. Positions for attachment may also be changed by your health care provider. Electrode patches are connected to the Holter recorder using the leads provided. Leads are taped on to the chest with stress loops to avoid inadvertent disconnection with movement. Fresh batteries are installed and the device switched on. A  beep sound will be heard and the display of the device will be active.

Some Holter recorders have a live display of the ECG, which will help to verify proper attachment of the patches. In such cases, electrode patches can be repositioned if needed, to get better waveform display. Make sure that the patches are attached well and do not produce artifacts in the display with movements. Identification details like ID number, date and recorder serial number can be entered in the patient diary for proper record.

Electromagnetic signals can interfere with the ECG recording. So electric razors, electric tooth brushes, magnets, electric blankets, metal detectors and microwave ovens are to be avoided during the recording period. Any other device likely to generate a high electromagnetic field near you has to be avoided. Mobile phones should be at least 15 cm away from the Holter system.