Search
HOLTER
Indications:
1) documenting symptomatic & asymptomatic arrhythmias in relationship to daily activities
- arrhythmia should occur at least daily* [2]
2) assessing the ventricular response to atrial fibrillation
3) assessing pacemaker function
4) confirming episodes of myocardial ischemia, not associated with angina pectoris
* use event recorder if symptomatic arrhythmia occurs less frequently than daily
Procedure:
- continuous monitoring of the electrocardiogram is conducted for a 24-48 hour period (generally 24 hours)
- patient log allows correlation with symptoms
Interpretation:
Highly probable pathologic rhythms:
1) sustained ventricular tachycardia
2) 2nd or 3rd degree heart block
3) prolonged pauses of > 3 seconds
Possibly pathologic rhythms:
1) brief runs of atrial fibrillation
2) supraventricular tachycardia
3) non-sustained ventricular tachycardia
4) frequent in elderly without syncope or presyncope
5) significant if symptoms accompany dysrhythmia
Adverse effects:
- device limits patient activities [2]
Related
electrocardiogram (ECG, EKG)
event monitoring (event recording, loop recording, Zio patch)
General
ambulatory arrhythmia monitoring
References
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed)
Lippincott-Raven, Philadelphia, 1998, pg 61
- Medical Knowledge Self Assessment Program (MKSAP) 11, 17, 18.
American College of Physicians, Philadelphia 1998, 2015, 2018.