Holter Monitor for Pediatric Heart Care

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

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

We use pediatric Holter monitors to get a more complete picture of the heart’s electrical activity and look for any problems. At Pediatric Cardiology Associates of Houston (PCAH), our specialists use Holter monitors for your child for periods from 24 hours to 14 days.

Why might my child need a Holter monitor?

If we suspect that your child may have an arrhythmia (irregular heartbeat), a Holter monitor can provide details. A Holter monitor test helps us diagnose arrhythmias by evaluating symptoms such as:

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

Our pediatric cardiologists may recommend a Holter monitor if:

• Your child experiences symptoms almost every day or symptoms that occur only during certain activities.
• A previous EKG showed a heart rhythm problem, even if your child doesn’t have symptoms.
• We need more information than a standard EKG provides to diagnose a heart condition.

We may recommend a cardiac event monitor if your child experiences symptoms less than once a week. Your child wears an event monitor for 30 days to record symptoms that happen only a few times a month.

Holter monitoring for children: What to expect

When we recommend Holter monitor testing for your child, we often provide it during the same office visit and set it up for you. Sometimes, we order the monitor to be mailed to your home with instructions for setting it up.

Preparing for Holter monitor test

If the monitor is being mailed to you, you can explain the test to your child before they get the monitor. Please tell them that it won’t hurt, but it might look scary.

• Your child can eat and drink normally while they wear it.
• Avoid using lotion, powder, cream or baby oil on your child’s chest on the day they’ll get the Holter monitor.

What happens during a Holter monitor test?

A Holter monitor, in most cases, is a small, sticky patch that we attach to your child’s chest. The patch is an electrode that will stay on for the entire time of the test.

Sometimes, we use a larger device connected to several patch electrodes. We place the electrodes on your child's chest and connect them to the Holter monitor with wires. Your child can put the small, portable device in their pocket or clip it to their clothing. Some Holter monitors come with a pouch and strap to wear around their neck or over their shoulder.

Your child can go about their usual activities after we attach the Holter monitor. We provide you with instructions about:

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

Guidelines for a successful Holter monitor test

• Don’t let your child go swimming or do other water activities, or do activities that may cause sweating.
• Keep a diary of your child’s activities while they wear the monitor.
  • Include the date and time of any changes in your child’s activities or symptoms.
  • Return the diary with the monitor.

Holter monitor results for children

The Holter monitor continuously records your child’s heart activity during the test, which may last from 24 hours to 14 days. After the monitoring period, you can take the patches off your child. Then, you will mail the monitor back to the device company. After the company sends us the test results, we go over them with you to decide next steps in your child’s heart care.

What are the risks of a Holter monitor for children?

As a safe, painless, noninvasive test, Holter monitoring has very low risks. The main risk is skin irritation or an allergic reaction to the adhesive in the patch electrodes. We can arrange for special electrodes that are gentler on your child’s skin, If they have sensitive skin.