Holter Monitoring in Children

A Holter monitor is a 24-hour recording of the electrical activity of the heart. The monitor is a diagnostic tool used to record the rate and rhythm of the heart.   

Irregularities such as fast heart rate (tachycardia), slow heart rate (bradycardia) and abnormal rhythms of the heart can be recorded.

Because many irregularities in heart rate or rhythm may not be present all of the time, a standard electrocardiogram (EKG) may miss them.

By recording the heart rate and rhythm continuously for 24 hours throughout the various activity levels a child goes through, there is a greater chance of detecting abnormalities.

Description of Holter Monitoring

The recorder is applied to the patient in the department of Cardiology by an experienced technician. The technician attaches five electrode patches (with wires) to the child's chest.

The electrodes are like conventional EKG patches and make it possible to record the heart's electrical activity. The wires are attached to a digital recorder that is worn for 24 hours on a belt around the waist or on a shoulder strap like a shoulder bag.

The patient or parents can remove the monitor after 24 hours or bring the child back to Cincinnati Children's Heart Institute for removal of the monitor.

If the parent removes the monitor, it should be brought back to the Heart Institute or shipped back via overnight delivery within 24 hours so the tracing can be analyzed.

A patient or parent may be asked to keep a log of activities during the day that the monitor is attached, especially recording any symptoms that develop that are suspected of being related to a cardiac rhythm problem. When the symptoms occur, the patient or parent should press the event button located on the recorder. The patient or parent will receive instructions on the “how and when” of pressing the event button.

Questions and Answers

Is a Holter monitor uncomfortable or painful?
The Holter monitor test can be a bit uncomfortable for some patients, as the electrodes and tape can irritate the skin, but it is not painful.

Is there any preparation needed for a Holter monitor?
There is no prior preparation for the test. If other tests are scheduled that day the Holter monitor must be the last test performed, as it has to be on for 24 hours. The child may not bathe or shower with the monitor or get it wet.

When are the results of the test available?
After the monitor is returned, a technician analyzes the recording within one business day. The cardiologist then interprets the results within one business day and the interpretation is faxed to the ordering physician.

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Last Updated 06/2020

Reviewed By Terra Hicks, Lead Cardiovascular Technician

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