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24 Hour ECG Monitoring or Holter Monitoring


This test monitors test monitors the hearts function over a 24 hour period.
 
Patient Guide to 24 hour ECG monitoring 
A 24 hour ECG (or Holter monitor) is a continuous tape recording of a patient’s ECG over 24 hours.  It is worn whilst the patient carries out their normal day to day activities, helping the consultant to correlate symptoms such as chest pain, palpitations and feinting.  It will also pick up heart rhythm abnormalities that are asymptomatic but may also reveal signs of ischemia (lack of blood supply to the heart).
 
Fitting of the 24hr ECG Monitor 
In preparation for the test it is ideal that the patient wears a loose fitting top, preferably with buttons down the front.  This makes it easier to apply the ECG electrodes and to wear the monitor itself.
The chest will be prepared by rubbing Skin Prep (rough paper) over the areas of electrode placement, followed by an alcohol wipe.  This ensures that residues and moisture are removed from the skin to allow for good fixture of the electrodes.

Some men may require areas of the chest to be shaved for the same reason.  Once dry, five electrodes will be placed over the chest and attached to thin wires on the monitor itself.  The technician will connect the monitor and check for a good recording.  Once satisfied the monitor will be placed into a small pouch that sits around the neck (like a necklace) or around the waist (like a belt).

Fitting of the monitor takes about ten minutes.

During the 24 hours 
The monitor should be worn for the full 24 hours.  The patient does not need to do anything with the monitor except remove it 24 hours later to be returned to the Practice.  Normal daily routines should be carried out as much as possible.  Unfortunately the monitors are not water proof so showering may be difficult during this period.  It is useful to take a diary of symptoms whilst wearing the monitor the correlation of the symptoms to heart rhythm abnormalities can be assessed.
 
After the 24 hours 
The technician will have provided the patient with an envelope to return the monitor back to the practice.  The electrodes are to be peeled off and the whole system to be placed in the envelope.  This is then ready to be returned.
 
Initially, the results are scanned by a cardiac technician and then passed on to the consultant cardiologist for assessment.  There is normally a three day interval between having the monitor fitted and receiving the results from the consultant cardiologist.
 

Investigations