Electrocardiograms (ECG)
Holter monitoring
ECG Holter monitoring allows for continuous recording of the heart rhythm during everyday life for a long period of time – 24 hours or more. The examination helps detect temporary or irregular heart rhythm disturbances.
What is it?
Holter monitoring is a test that allows the doctor to monitor your heart rhythm for an extended period of time – not just for a few seconds, as with a conventional electrocardiogram (ECG), but around the clock or even for several days.
During the examination, the electrical activity of the heart is recorded, similar to a regular ECG, but here the recording takes place continuously for 24 hours, and in some cases for 48 hours or up to 7 days.
This helps detect irregular or temporary changes in heart rhythm that a regular ECG often fails to capture.
How is it done?
The doctor attaches several small electrodes to the patient's chest, which are connected to a small recording device called a Holter monitor. The patient wears this device with them throughout the examination – usually attached to a belt or worn in a small pouch around their neck. The device is lightweight and comfortable, so the patient does not have to change their usual daily routine.
The electrodes detect and record electrical signals generated by the heart. The electrodes do not conduct current through the body and do not cause any discomfort.
Holter monitors can vary in design. Some models have multiple electrodes and wires connected to a small, portable device, similar to an ECG. This type of device provides a more accurate and detailed ECG recording because the signal is collected from multiple points on the chest.
Wireless Holter monitors, on the other hand, are very compact and are attached directly to the front of the chest. Such devices are almost invisible under clothing and are less disruptive to daily activities, but their recording can be slightly less accurate because only three electrodes are used.
The doctor selects the most appropriate Holter monitor depending on the patient's complaints, the expected duration of the recording, the required data accuracy, and daily activities during the examination.
After a certain amount of time, the patient returns to the doctor, where the monitor is removed, and the data obtained is analyzed to assess the heart rhythm in various situations.
Putting on the device and explaining how to use it takes approximately 10–15 minutes, but you should plan at least 30 minutes for the entire visit.
When is it needed?
Holter monitoring is most often recommended if:
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there is a complaint such as chest pain, palpitations, heart palpitations or "pounding", unexplained dizziness or loss of consciousness, as well as shortness of breath, especially during exercise, but a regular electrocardiogram cannot be performed at the time of the complaint to determine what is happening at a certain moment;
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the heart tends to beat unevenly or irregularly;
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have had a loss of consciousness or a feeling that you might lose consciousness;
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dizziness, weakness or fatigue appear for no apparent reason;
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it is necessary to assess the effectiveness of treatment for already known heart rhythm disorders;
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the pacemaker should be checked;
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in other cases, upon the doctor's advice.
How to prepare?
Holter monitoring usually does not require any special preparation, but there are some practical suggestions:
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It is recommended to take a shower before putting on the device, as you should not shower with the device in place.
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Do not use creams, oils, or lotions on your chest on the day of the examination – they may interfere with the adhesion of the electrodes.
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Wear comfortable, loose clothing so that the electrodes and device are easily hidden and do not hinder your movements.
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Do not wear metal jewelry around your neck (if the device is worn on a strap).
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If you are taking medication for your heart or blood pressure, continue taking it as usual unless your doctor tells you otherwise.
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During the appointment, live your life as usual – go to work, go for walks, etc. – but note any complaints, feelings, or events (e.g., physical activity, stress, rest) in your diary.
Learn how to prepare for a doctor's consultation at the Medica Riga clinic.