A Holter monitor is a small, portable ECG recorder that you wear while you go about your normal life. It records every heartbeat, usually for 24 hours to 14 days, to catch irregular rhythms or symptoms such as palpitations that a short ECG in a clinic might miss. It is painless, and most people quickly forget they are wearing it.
What is a Holter monitor and why is it used?
A standard resting 12-lead ECG takes only a few minutes and records a short snapshot of your heart's electrical activity. That is very useful, but many heart rhythm problems come and go. If your heart is behaving normally during that short recording, the ECG may look normal even if you have symptoms at other times.
A Holter monitor solves this by recording continuously over a longer period. Your clinician may suggest one if you have:
- Palpitations, such as a racing, fluttering, pounding or skipping heartbeat
- Dizziness, light-headedness or unexplained fainting
- Episodes of breathlessness or chest discomfort that come and go
- A known rhythm problem, such as atrial fibrillation, that needs checking
- Medicine or a pacemaker whose effect on your heart rhythm needs reviewing
If palpitations are your main concern, our guide on palpitations and which heart test you need explains the options.
How does a Holter monitor work?
Small sticky pads called electrodes are placed on your chest. They pick up the tiny electrical signals your heart makes with each beat. Thin wires connect the electrodes to a small recorder, which you wear on a belt, clip or strap, or which sits directly on your chest, depending on the device.
The recorder stores your heart rhythm the whole time you wear it. When the recording ends, the data is downloaded and analysed. A clinician looks at your heart rate, any pauses, extra beats or abnormal rhythms, and compares them with the times you noted symptoms.
The monitor only records. It does not send any electricity into your body, and it cannot change how your heart beats.
How long should you wear a Holter monitor?
The right length depends on how often your symptoms happen. The general rule is simple: the less often you notice symptoms, the longer the recording should be, so there is a good chance of catching an episode.
| Duration | Often suited to | Price |
|---|---|---|
| 24 hours | Symptoms most days | £250 |
| 48 hours | Symptoms every day or two | £275 |
| 72 hours | Symptoms every few days | £295 |
| 7 days | Symptoms roughly weekly | £325 |
| 14 days | Occasional or hard-to-catch symptoms | £350 |
All prices include the test, clinical review and written report. If you are not sure which length is right for you, we can help you choose, and your clinician will advise if you have been referred.
What can and can't you do while wearing a Holter monitor?
The aim is to record your heart during a normal day, so carry on with your usual routine as much as you can. That includes work, walking, light exercise if it is part of your normal life, and sleeping.
There are a few things to keep in mind:
- Showering and bathing: most Holter recorders are not waterproof, so you usually cannot shower, bathe or swim while wearing one. Have a wash before your fitting. Some patch-style monitors can cope with a quick shower, so always follow the instructions for your device.
- Keep the electrodes in place: avoid pulling on the wires, and do not remove the pads unless you have been told how to replace them.
- Clothing: loose, comfortable clothes make the monitor easier to wear. Avoid applying body lotion or oil to your chest, as this can stop the pads sticking.
- Electrical items: phones and most household appliances are generally fine. Do not sleep under an electric blanket that is switched on, avoid standing directly in front of a microwave while it is running, and do not use a TENS machine, as these can interfere with the recording.
- Exercise: gentle activity is fine and can be useful, especially if your symptoms happen when you are active. Heavy sweating may loosen the pads.
Why is the symptom diary important?
You will be asked to keep a simple diary while you wear the monitor. This is one of the most useful parts of the test.
Each time you notice a symptom, write down:
- The date and time
- What you felt, such as fluttering, a thump, dizziness or breathlessness
- What you were doing at the time, for example climbing stairs, resting or lying in bed
It also helps to note when you exercised, took medicine, had caffeine or alcohol, went to sleep and woke up. Some monitors have an event button you press when you feel a symptom. The clinician can then match your diary entries with your heart rhythm at that exact moment. If your rhythm is normal when you feel symptoms, that is reassuring and useful information too.
How does the self-fit Holter kit work?
If it suits you better, a self-fit Holter kit can be posted to your home with clear instructions. This means you do not need to travel to a clinic or wait in for a visit.
The kit includes everything you need to fit the monitor yourself. You follow the step-by-step instructions to place the electrodes and start the recording, then wear it for the agreed length of time and keep your diary as normal. When the recording is finished, you return the monitor as explained in your instructions, and the data is analysed in the same way as a clinic-fitted test.
If you would rather have the monitor fitted for you, you can visit our Luton clinic or book a home visit instead.
What happens after the recording?
Once the monitor is returned, your recording is analysed and reviewed. You will receive a written report, usually within 24 working hours, with Consultant Cardiologist oversight. The report explains your heart rate, rhythm and any findings, and whether they match the symptoms in your diary.
Depending on the results, you may be advised to share the report with your GP, have further tests such as an echocardiogram, or simply be reassured. A Holter monitor records your rhythm, but it does not diagnose every heart condition on its own.
Please remember that a Holter monitor is not an emergency alarm. If you have chest pain, collapse, severe breathlessness or fainting while wearing it, call 999 straight away. For other worrying symptoms, speak to your GP or call NHS 111.
Frequently asked questions
Does a Holter monitor hurt?
No. The sticky pads may feel a little itchy, and removing them can feel like taking off a plaster, but the test itself is painless.
Can I sleep with a Holter monitor on?
Yes. Sleeping with it on is important, as some rhythm problems happen at night. Try to lie in a way that does not pull on the wires.
Can I shower with a Holter monitor?
Usually not, as most recorders are not waterproof. Wash before your fitting and follow the instructions for your specific device.
Is a 24-hour Holter long enough?
It is often enough if you have symptoms every day. If your symptoms are less frequent, a longer recording of 48 hours to 14 days gives a better chance of catching them.
Do I need a GP referral for a Holter monitor?
No. You can refer yourself to The Heart Clinic, and GP or specialist referrals are also accepted.
Booking a Holter monitor with The Heart Clinic
The Heart Clinic offers Holter monitoring from 24 hours to 14 days, at our Luton clinic, through home visits across London, Hertfordshire and Buckinghamshire, or with a self-fit kit posted to your home. See our prices or contact us on 07853 215671 to book.