Holter Monitor Referral

• Fainting episodes 

• Shortness of breath without any reason 

• Unexplained palpitations 

• Chest discomfort  

• Irregular heartbeat noticed during a routine ECG 

In Australia, a GP or cardiologist may refer a patient for Holter monitoring when:  

• A routine ECG may miss symptoms that occur occasionally. 

• Symptoms develop during everyday activities. 

• Monitoring may be advised following a cardiac event. 

• To check whether heart rhythm medications are working fine. 

• To identify or confirm irregular heart rhythms. 

A Holter monitor may help identify:  

• Irregular heart rhythms (arrhythmias)- abnormal electrical activity affecting heart rhythm. 

• Atrial fibrillation- fast, irregular beating in the upper heart chambers. 

• Bradycardia- slower than normal heartbeat 

• Tachycardia- unusually rapid heart rate 

• Unexplained palpitations– noticeable heart fluttering or pounding 

• Management monitoring– tracking how effectively medications or pacemakers are managing your heart rhythm. 

Ambulatory monitoring tracks heart activity for longer periods during routine life rather than when in a hospital. 

Common types include:  

• 24-hour Holter monitor: Continuous monitoring for one whole day 

• 48-hour Holter monitor: Longer monitoring to help detect less frequent events 

• Extended event monitor: A wearable device used over several days or weeks, activated when symptoms occur. 

• Patch monitor: A compact adhesive device placed on the chest that records heart activity continuously. 

A Holter monitor records continuous ECG data, including heart rhythm, heart rate fluctuations, and electrical signals of the heart. Patients may also keep a symptom diary to help doctors correlate them with the ECG data.

Holter monitoring has the following limitations: 

• It may not detect very rare symptoms. 

• The accuracy of the recording depends on the electrodes being placed on the chest. 

• It measures only the heart’s electrical activity and does not assess structural heart problems. 

• Wear comfortable clothing 

• Take a shower before the test because the device should not be exposed to water. 

• Not to apply moisturisers, oils, or lotions on the chest 

• Continue daily activities normally unless advised otherwise 

• Keep a record of symptoms and activities in a diary during monitoring.