24 hours Holter monitoring

Holter Monitoring

Holter monitoring is a non-invasive diagnostic test that records the heart’s electrical activity continuously over a 24-hour period and allows observation of rhythm changes during normal daily activities. This long-term electrocardiogram (ECG) recording helps detect not only frequent but also episodic, intermittent heart rhythm disturbances that often go unnoticed during a standard short ECG. The test is performed at multidisciplinary clinics “Meliva” (formerly “Kardiolita Clinics”).

When is Holter monitoring performed?

Holter monitoring is most commonly prescribed for patients in whom heart rhythm disturbances are suspected. The test may be important in the following cases:

• experiencing palpitations, skipped beats, or episodes of rapid heart rate
• sudden dizziness or fainting
• frequently fluctuating blood pressure
• follow-up after treatment of arrhythmias or interventional procedures
• assessing treatment effectiveness or selecting appropriate medication

The test is prescribed by a cardiologist after evaluating symptoms and the clinical situation.

How is the test performed?

During the test, several electrodes (usually 3–5) are attached to the patient’s chest and connected by wires to a small portable recording device. In some cases, if needed, the monitoring period can be extended to 48 hours or longer to capture less frequent rhythm changes.

The device records all electrical impulses of the heart throughout the monitoring period and is typically worn on a belt around the waist. During the test, patients continue their normal daily activities—working, walking, and resting.

If symptoms occur, they are usually recorded in a diary along with a description of the activity at that time. After the test, the device is removed and the data are transferred to an analysis system. A cardiologist evaluates the results.

Although the test does not cause discomfort, some restrictions are important:

• avoid showering or bathing, as moisture may affect the electrodes
• during sleep, lie on your back or side to prevent electrodes from detaching

It is important to note that the test is painless and safe. It does not interfere with breathing, movement, or general well-being, while providing highly valuable information about heart rhythm under normal conditions.

What parameters are evaluated during the test?

The following main parameters are assessed during Holter monitoring:

• heart rate (minimum, maximum, average)
• extrasystoles – premature heartbeats (atrial or ventricular)
• bradycardia episodes – slower than normal heart rate
• tachycardia episodes – increased heart rate at rest
• heart rhythm response to physical activity and rest
• pauses between heartbeats
• possible episodes of atrial fibrillation or flutter
• signs of ischemia – indicators of insufficient oxygen supply to the heart muscle (ST segment changes)

When interpreting the results, the patient’s diary is also important. It records not only symptoms but also physical activity and emotional stress, helping to correlate heart rhythm changes with specific situations and enabling more precise data interpretation.