A rhythm holter or ECG holter is a test done to check for a heart rhythm disorder. Find out how it works, what are the precautions for this registration to be successful? The essentials to know about the rhythmic holter.

A rhythmic holter or ECG holter also called holter from 24 hours (to 48 hours) is a device for recording the electrocardiogram (ECG) of a person, for 24 to 48 hours most often, but this can be extended up to 7 days. It is the same as a resting electrocardiogram (ECG) but the recording takes longer.

This test was invented by an American biophysicist, Norman Holter. The Holter ECG continuously records the cardiac electrical signal in order to diagnose a possible rhythmic disorder, in particular in the presence of unexplained syncope, palpitations, a cardiac conduction problem. It is also used to monitor the progress of a treatment.

Composition

A rhythmic holter is a portable device, composed of a small case worn over the shoulder or on a belt, connected by wires to 3-6 self-adhesive electrodes (depending on the model) placed on the skin of the thorax. The case worn on a belt or over the shoulder is no more cumbersome than a cell phone or a walkman. Depending on the type of hardware, it works with a blank floppy disk or an SD / micro SD card.

Holter ECG recording is performed in order to detect possible abnormal heart rhythms, ventricular (in the ventricles) or supraventricular (regions above the ventricles) rhythm disturbances or conduction abnormalities leading to episodes of bradycardia. (heart rate slower than normal).

Rhythmic holter indications

A holter recording is indicated at:

• during a workup after an ischemic stroke;
• during an assessment of unexplained ailments in a person who has experienced “palpitations”;
• to test for paroxysmal rhythm or conduction disturbances during the evaluation of antiarrhythmic therapy or when testing for ECG abnormalities in favor of myocardial ischemia with or without pain.

Public concerned or at risk

Generally speaking, you may need a Holter monitor if you have symptoms such as:

• discomfort;
• syncope;
• palpitations;
• tachycardia sensations.

More particularly, if they are caused by a heart rhythm disorder and they occur with sufficient frequency, to monitor treatment for a heart rhythm disorder or to make the diagnosis of coronary insufficiency.

A holter may also be prescribed for you, if you have had a myocardial infarction or if you have a pacemaker.

The stages of operation

The rhythmic holter is placed by the doctor. The skin is cleansed and degreased beforehand, possibly shaved in men. The patches are put in place, the cables connected and fixed with adhesive tape. The holter monitor is placed on the waistband of your pants or on a belt that you can loan if you are not wearing one. The installation lasts about 20 minutes.

Do I have things to do?

There is an event marker button on the case. You should activate it in the presence of symptoms: discomfort, palpitations, pain. These symptoms should also be recorded on the paper sheet.

You must also note on the sheet given at the time of the installation of the holter the significant events of your day:

• hours to get up;
• to sleep ;
• meal ;
• taking medication;
• physical effort ;
• etc.

Once the 24-hour recording is complete, the case must be removed, peeling off the plasters and electrodes (without using a sharp object such as a knife or scissors) and bring it back for analysis.

Precautions to take

Before fitting a holter, do not put cream or lotion on the chest. Take your medication as usual and put on a comfortable, loose-fitting outfit with an easily removable top (no dress, for example).

After installation, the device must not get wet, you will not be able to take a bath, shower or go to the swimming pool. You can wash yourself with a glove.

You can work and do your usual activities with a holter, but avoid activities such as contact sports as the device should not be subjected to severe impact.

During the night, the device should be placed near you.

Do we have to repeat this exam?

It is sometimes necessary to repeat an ECG holter several times, this to detect an abnormality of rare occurrence.

The different models

The Holter ECG recorder has evolved a lot, from a limited recording on audio cassettes (approximately 1 hour of time), to a longer storage of the heart’s electrical signals on an SD memory card.

Some holters measure blood pressure in addition to the ECG tracing.