A Holter monitor is a battery-operated portable device that measures and records your heart’s electrical activity (electrocardiogram)
continuously for 24 to 48 hours or longer depending on the type of monitoring used. The device is the size of a small camera. It has wires with small electrodes that attach to your skin.

You may be asked to wear a Holter monitor to see if you have a slow, fast or irregular (uneven) heartbeat. Or your doctor may use it to
see how well your medication is working to treat these symptoms.
You might have symptoms such as:

• Fainting
• Dizziness
• Shortness of breath
• Chest pain
• Irregular heartbeat (arrhythmia)

Your doctor may suggest you wear a Holter monitor for a day, even if you haven’t had any symptoms of an abnormal heartbeat.

If you have a pacemaker and feel dizzy, your doctor may use a Holter monitor to find out if your pacemaker is working properly.

The results of wearing a Holter monitor will help you and your doctor decide if you need more tests or medication for your heart, or if you need a pacemaker or cardioversion procedure to restore a regular heart rhythm.

Wearing a Holter monitor has no risks and causes no pain. Holter monitors have wires that connect to small electrodes attached to your chest to record the electrocardiogram.

Because the electrodes are attached with adhesives, on rare occasions, they may cause mild skin irritation which should resolve within a day.

There’s not a lot you need to do to prepare – but it is recommended that you shower before the test. After your holter monitor has been fitted, you cannot get it wet or remove it. For men, a small amount of hair on the chest may need to be shaved to help the electrodes stick to your skin.

Wearing loose fitting clothes will help make it more comfortable whilst also concealing the monitor.

A specially trained nurse, cardiac technologist or doctor will attach the Holter monitor and instruct you on how to record your symptoms while wearing it.

The nurse first attaches the electrodes to your chest. If you have hair on your chest, he or she may shave some hair to attach the electrodes firmly.

• Once the electrodes are in place, the nurse helps you put the Holter monitor on and explains how to take care of it.
• You can carry the monitor around your waist or attached to a strap around your neck.

Do your usual activities while you wear the monitor with these exceptions:

• Do not bathe, shower or swim while wearing the monitor.
• Do not have X-rays while wearing the monitor.
• Stay away from high-voltage areas, metal detectors or large magnets.

The nurse will show you how to activate the symptom button during the test. It’s important to activate this button if you feel symptoms such as chest pain, shortness of breath, uneven heartbeats (palpitations) or dizziness.

Your doctor will discuss these events and their results during your follow-up consultation.

After the test period, remove the monitor as instructed by the nurse and return the monitor to the clinic.

At least 36hrs is required for the recording to be adequately analysed and reviewed by one of our cardiologists.

Your doctor will then discuss your results and recommend an appropriate treatment plan to help you manage your symptoms moving forward.

Blood pressure normally fluctuates over the course of the day, particularly in response to stress and exercise. When you have your blood pressure measured in the clinic by your doctor, it is sometimes significantly higher than what you might have obtained at home. A common cause for this is “white-coat hypertension,” where the stress of going to see the doctor increases your blood pressure.

This can lead to the doctor inadvertently starting treatment for high blood pressure, which can lead to side effects as well as additional costs.

To avoid this, blood pressure should be measured outside the clinic while you are going about your usual activities. Ambulatory blood pressure monitoring allows your blood pressure to be measured frequently over the course of 24 hours, including while you sleep.

By taking multiple blood pressure measurements when you are awake and asleep, it allows an average to be calculated. This average has been shown to be more representative of your actual blood pressure and is therefore more predictive of future complications such as stroke and heart attack.

a. Identification of “white-coat hypertension” (a higher blood pressure induced by having a doctor measure it), thereby preventing inappropriate treatment with blood pressure lowering drugs

b. Because night-time blood pressures are measured, conditions that raise the blood pressure excessively at night such as obstructive sleep apnoea can be identified and treated

c. Spikes and dips in blood pressure can be clearly identified allowing for better treatment

A 24Hr BP monitor performs blood pressure measurements far more frequently than could be possible even with a home blood pressure monitor. It also measures blood pressure at night-time, whilst you are asleep (which is difficult to do with a home BP monitor).

Additionally, because of the small size of the monitor, it can be used at work, hidden under clothing and other settings where a usual home BP monitor would be too cumbersome.

Finally, the results obtained with a 24hr blood pressure monitor have been compared with those obtained with home BP monitoring and have been found to be more accurate and useful in predicting future complications of high blood pressure.

A standard upper arm cuff of an appropriate size is put on your arm. This is usually put on your non-dominant arm (the opposite to the one used in writing) and attached to a small battery powered pump and recorder (SunTech Oscar 2). The pump inflates the pressure in the cuff to above your maximum (or systolic) blood pressure and gradually releases the pressure to below the minimum (diastolic) pressure in time with the pulse.

The device emits a sound when it is about to take a measurement. It is important that your arm is kept still during this measurement. If the machine is unable to measure the blood pressure properly, it will attempt to do so again and again. When the cuff is at maximum pressure, the blood supply to the arm below the cuff is cut off for a few moments.
If your blood pressure is very high, the pump will have to inflate the cuff up to a higher pressure and this may be uncomfortable.

Some bruising may occur, particularly if you are on medications to thin the blood (aspirin, warfarin, other blood thinning medications).

However, if pain or any other worrying symptoms occur, it is best to remove the device and turn it off.

A standard upper arm cuff of an appropriate size is put on your arm. This is usually put on your non-dominant arm (the opposite to the one used in writing) and attached to a small battery powered pump and recorder (SunTech Oscar 2). The pump inflates the pressure in the cuff to above your maximum (or systolic) blood pressure and gradually releases the pressure to below the minimum (diastolic) pressure in time with the pulse.

The device emits a sound when it is about to take a measurement. It is important that your arm is kept still during this measurement. If the machine is unable to measure the blood pressure properly, it will attempt to do so again and again. When the cuff is at maximum pressure, the blood supply to the arm below the cuff is cut off for a few moments.
If your blood pressure is very high, the pump will have to inflate the cuff up to a higher pressure and this may be uncomfortable.

Some bruising may occur, particularly if you are on medications to thin the blood (aspirin, warfarin, other blood thinning medications).

However, if pain or any other worrying symptoms occur, it is best to remove the device and turn it off.

Your doctor may decide to repeat the 24hr monitor to monitor treatment (after the commencement or cessation of a blood pressure lowering medication) or to clarify a borderline result.

At least 36hrs is required for the recording to be adequately analysed and reviewed (to ensure that erroneous recordings have not been inadvertently included).