Holter monitoring

Abstract

Holter monitoring represents avaluable diagnostic tool to document intermittent arrhythmias in the work-up of, for example, syncope, presyncope, collapse, falls, dizziness, stroke, palpitations, and arapid heartbeat. In addition, it may help in the diagnosis of intermittent ischemia and channelopathies, particularly in the form of 12-lead Holter monitoring. Continuous ECG registration typically lasts from 24-48 h. The use of Holter monitoring is limited in patients with rare symptoms (< 1 × per month) and in recordings full of artifacts. The interpretation of aHolter recording combines an automatic analysis with amanual reassessment. The clinical relevance of many arrhythmias can only be considered together with symptoms and activity of the patient at the time of the event. Therefore, apatient diary accompanying the ECG recording is crucial. Systematic assessment of the ECG recording and knowledge about anumber of pitfalls in Holter monitoring can optimize the interpretation of the recording.