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Holter Monitors for Children’s Heart Care

Holter Monitor for Children’s Heart Care

A Holter monitor is a small, portable device that continuously records the heart’s electrical activity for 24 hours or longer. Your child wears the device at all times during their regular daily activities, such as going to school, playing, eating and sleeping.

Holter monitoring is a painless and noninvasive (doesn’t enter the body) test that works like a standard electrocardiogram (EKG or ECG). Because a standard EKG records heart activity only for a few seconds, it may miss symptoms that come and go.

A Holter monitor provides a more complete picture of the heart’s electrical activity so we can see problems that may be causing your child’s symptoms. At Pediatric Heart Specialists (PHS), we use pediatric Holter monitors for periods from 24 hours to 14 days.

What is a Holter monitor used for?

A Holter monitor measures the heart’s electrical activity, which controls heart rate and rhythm by sending mild electric signals through heart muscle. These signals coordinate contractions in the heart’s chambers to pump blood through the heart and to the lungs and body.

Our pediatric cardiologists use Holter monitors if we suspect that your child may have a problem with their heart rate or rhythm, called an arrhythmia. Your child might need Holter monitoring if:

  • A standard EKG doesn’t provide enough information to diagnose a heart condition.
  • They experience symptoms several times a week or only during certain activities.
  • A previous EKG showed an unusual heart rate or rhythm, even if your child doesn’t have symptoms.

Our pediatric cardiologists use a Holter monitor test to help diagnose arrhythmia by evaluating symptoms such as:

  • Dizziness
  • Fainting
  • Heart palpitations (a feeling of the heart racing, pounding or skipping beats)
  • Shortness of breath
  • Unexplained fatigue
  • Chest pain

If your child experiences symptoms less often, we may recommend a cardiac event monitor. Your child wears an event monitor for 30 days to capture irregular heart rhythms that happen only a few times a month.

Wearing a Holter monitor: What to expect with children

If we recommend a Holter monitor for your child, we usually provide it during the same office visit. Sometimes, we order the device and have it mailed to your home with instructions.

How do I prepare my child for wearing a Holter monitor?

Before you receive the monitor, explain the test to your child. You can tell them that it might look scary, but it won’t hurt.

  • Your child can eat and drink as usual while wearing it.
  • Don’t use cream, lotion, powder or baby oil on your child’s chest before putting on the Holter monitor.

What happens during Holter monitoring?

In most cases, the device is a small patch that we attach to your child’s chest. The patch, an electrode, is sticky and will stay on for the entire time of the test, up to 14 days.

Sometimes, we use a larger Holter monitor connected to several patch electrodes. We place them on your child's chest and connect them to the Holter monitor with wires. The monitor is a small, portable device that your child can put in their pocket or clip to their clothing. It may have a strap and pouch so they can wear it around their neck or over their shoulder.

After we attach the Holter monitor, your child can go about their usual activities. We provide you with instructions about:

  • How to keep the electrodes attached to your child's skin
  • How to check the device for problems
  • Whom to call if you need help with the monitor
  • How to keep the monitor and electrodes dry while bathing your child

Tips for accurate Holter monitor results

  • Your child should avoid water activities, such as swimming, and activities that may cause them to sweat heavily.
  • Write down your child’s activities while they wear the monitor.
    • Make note of the date and time of any symptoms your child experiences.
    • Send the record of your child’s activities and symptoms back with the monitor.

Holter monitor results for children

The Holter monitor continuously records your child’s heart activity during the entire time of the test. After the monitoring period, you can take the patches off your child and mail the monitor and activity record back to the device company. The company sends us the Holter monitor results, and we review them with you to decide on the next steps in your child’s heart care.

What are the risks of a pediatric Holter monitor?

Holter monitoring is a safe, painless, noninvasive test. The only risk is skin irritation or an allergic reaction to the adhesive in the patch electrodes. If your child has sensitive skin, we can arrange for special electrodes that are gentler on their skin.

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