Holter ECG Test (24-hour Ambulatory Electrocardiogram Monitoring)
What is a Holter ECG?
The Holter ECG is a non-invasive diagnostic test that continuously records the heart’s electrical activity over 24, 48, or more hours using a small portable device connected to electrodes placed on the chest. It is named after the American biophysicist Norman Holter, who developed the technique in the 1960s.
What is it for?
It is used to detect heart rhythm abnormalities that may not appear during a standard ECG, which records only a few seconds. It allows monitoring of the heart’s activity during everyday life, sleep, physical exertion, and emotional or physical stress.
Main Indications
- Palpitations or the sensation of a “racing heart”
- Suspected ventricular or supraventricular arrhythmias
- Unexplained syncope or transient loss of consciousness
- Monitoring of patients with pacemakers or implantable defibrillators (ICDs)
- Assessment of antiarrhythmic therapy efficacy
- Evaluation of rhythm disorders in known cardiac patients
How is it performed?
Electrodes are placed on the chest and connected to a portable recorder, about the size of a mobile phone, which the patient wears for 24 hours or more. Patients are asked to continue their normal daily activities and keep a diary of any symptoms (dizziness, palpitations, chest pain) and activities performed.
After the recording, the data is downloaded and analyzed by a cardiologist who assesses the heart rhythm, frequency, any arrhythmias, and their correlation with symptoms.
What clinical data can be obtained?
- Presence, frequency, and type of arrhythmias (ectopic beats, atrial fibrillation, flutter, paroxysmal tachycardias)
- Pauses or atrioventricular blocks
- Chronotropic response during physical or emotional stress
- Evaluation of pacemaker or ICD function, if present
- Correlation of symptoms with heart rhythm
Scientific References and Guidelines – Holter ECG
- ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy (2021)
European Society of Cardiology (ESC)
Relevance: use of Holter ECG in monitoring implantable devices (PM and ICD) and diagnosing bradyarrhythmias.
Link: ESC Guidelines 2021 – Pacing and CRT - ESC Guidelines for the Management of Patients with Supraventricular Tachycardia (2019)
Holter ECG is recommended as a first-line test for documenting suspected tachyarrhythmias.
Link: ESC Guidelines 2019 – SVT - ANMCO-AIAC Italian Guidelines – Management of Cardiac Arrhythmias
Published in Giornale Italiano di Cardiologia
National clinical applications of Holter ECG in diagnosis of atrial fibrillation, flutter, and complex ectopy. - ESC Guidelines on Syncope (2018)
Holter ECG is recommended in unexplained syncope for suspected intermittent arrhythmias.
Note for website readers
“All described tests are performed according to the recommendations of major international scientific societies and in line with ESC/ESH Guidelines and Italian clinical practice standards.”
How to Book a Holter ECG
To schedule an exam or request more information, please contact our center:
Studio Medico Dr. Salvatore Tribastone
Phone: +39 324 847 1011
Email: segreteria@tribastone.it
Please note: this service is available for the Catania Area only