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​Holter Monitoring

Holter monitoring is a test used to detect possible heart-related problems when you experience symptoms like dizziness, irregular heartbeats or
fainting. Holter monitoring is most commonly used to detect cardiac arrhythmias.

What are Cardiac Arrhythmias?

Cardiac arrhythmias or abnormal heartbeats, is a group of conditions in which the heart beats too fast, too slow or erratically. A person with cardiac
arrhythmia may have unexplained dizziness or fainting, palpitations or in some rare cases, may experience no symptom at all. Your doctor may
be the first to notice signs of an arrhythmia. This will probably be during a routine physical exam when they listen to your heartbeat or perform an
electrocardiogram (ECG).

Some arrhythmias can increase the risk of stroke, heart attack, heart failure, or sudden cardiac death (which kills over 40,000 Canadians a year). Atrial fibrillation is the most common serious arrhythmia and affects about 2% to 3% of people in North America and Europe.


What happens if I have Atrial fibrillation?

Atrial fibrillation is a widespread arrhythmia, affecting approximately 350,000 Canadians. The risk
of developing atrial fibrillation increases with age and with other risk factors such as diabetes, high
blood pressure and underlying heart disease. The main complications of atrial fibrillation are stroke
and heart failure. People with atrial fibrillation have a risk of stroke that is 3 to 6 times greater than
people without atrial fibrillation.


Atrial fibrillation can also lead to heart failure. Heart failure is a condition in which your heart can’t
circulate enough blood to meet your body’s needs. Atrial fibrillation’s irregular, fast heart beat leads
to ineffective pumping of the blood which – especially if not controlled – may weaken the heart.

How does Holter Monitoring work?

A holter monitor is a small, lightweight recording device with sensors that are attached to your chest.

This device monitors your heart’s electrical activity as you go about your daily routine, at home or
work. The recorder is typically attached to your chest for 24 hours, but a longer duration can be
chosen based on how often your symptoms appear. This is especially useful if your symptoms are
intermittent and not detected during an ECG test.

Your heart’s rhythm is transmitted and recorded, then played back into a computer so it can be analyzed by a cardiac technologist and confirmed by a cardiologist to find out what is causing your arrhythmia.

Who should get tested?

If you have unexplained palpitations, dizziness, fainting, shortness of breath, anxiety or fatigue, or if you have a family history of sudden cardiac death, your doctor may recommend holter monitoring.


 Abnormal heart rhythms and other types of cardiac symptoms can come and go. Monitoring for
a longer period of time is necessary to record these events. The Holter monitor lets your doctor
see how your heart functions on a long-term basis.

If you’re already being treated for heart problems, wearing your monitor can help your doctor
determine if your medicine is working or if changes need to be made.

How is the test performed?

Your doctor will provide you with a requisition form and book an appointment for you at a specific LifeLabs location. Your requisition form will indicate the duration of recording, which can vary from 24 hours to 2 weeks.

At your appointment, you can expect the following:

  1. A few small areas of your chest will be cleaned, marked and prepared for attaching the
  2. The sensors will be attached to your skin with tape
  3. A cable will connect the skin sensors to a small monitor, which is placed in a holder attached
    to your belt or clothes
  4. The monitor is small enough that it allows you to continue with your normal daily activity.
  5. The monitor will continuously record your heart’s activity until disconnected.
  6. Hookup appointment usually takes 30 minutes to an hour. You may be asked to keep an
    activity journal / diary, so your heart rhythm can be correlated to your daily activities
  7. Once the recording duration is over, you must return to the same LifeLabs location. The
    disconnect appointment takes approximately 15 to 30 minutes.

How do I prepare for the test?

Make sure your appointment is booked for both hookup and disconnection, and if your doctor
has given you a paper requisition, bring it with you.

  • Shower or bathe just prior to your appointment.
  • DO NOT use talcum, lotions or perfumes.
  • Wear a comfortable outfit, which opens in the front.
  • Bring a list of all current prescribed medication and herbal remedies.
  • For patients with pacemakers, please bring your Pacemaker Card with the latest setting.
  • Women should not wear full slips. Instead, wear a comfortable bra, as you will be required to
    wear it during the entire recording duration.
  • Men should be aware that shaving will be required to remove any chest hair where sensors
    are attached

Understanding your results

Your results will be sent to your doctor shortly after your disconnection appointment. Your
doctor will read your activity journal and analyze the results of the monitor. Depending on the
results of the test, you may need to undergo further testing before a diagnosis is made.

The Holter monitor may reveal that your medicine isn’t working or your dosage needs to be
altered if you’re already taking medication for an abnormal heart rhythm. It’s especially useful in
detecting abnormal heart rhythms that are painless and unknown to you.


How is the test performed?

This is a non-invasive test in which you will wear a recording device for a specific duration of time.

How much does it cost?

There is no charge for this test if you have provincial health coverage in Canada.

When will I get my results?

Your results will be available to your healthcare provider within 1 week.

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