The Holter Monitoring test does not require any special preparation as it is a non-invasive procedure. The Holter monitor is about the size of a small cell phone and is typically used for 24-48 hours with a battery life of 80-100 hours.

The Holter Monitoring test is a simple procedure. The technician will explain the examination procedure and educate the patient about any complaints that may arise during the test, such as chest pain, shortness of breath, or headaches. The technician will attach electrodes to the patient's chest. Once attached, the electrodes will receive signals from the heart and send them to a portable recorder for storage. The stored recordings will then be converted into a report and analyzed by a Cardiologist. While the electrodes and the recording monitor are attached, patients can continue their normal activities and routines.

Holter Monitoring tests generally use 2-3 leads, but can also use 12 leads depending on the desired goal. The use of 2-3 leads is sufficient to monitor heart rate and rhythm. However, if the goal is to determine the source of premature beats/arrhythmia or tachycardia, 12 leads can be used for higher accuracy.

The choice of monitor to be used depends on the frequency of symptom occurrence. If symptoms are continuous, a routine 12-lead Holter Monitoring test is sufficient for diagnosis. Cardiologists generally use the Holter monitor to detect symptoms that appear intermittently. If symptoms appear less frequently, devices with longer durations, such as an implantable loop recorder (ILR) or event monitor, are used.

During the examination, patients can note symptoms such as fainting, palpitations, chest pain, etc. These notes will help the cardiologist match the symptoms with the heart recordings on the monitor.

Some important points to note during the Holter Monitoring test include:

• There are no medication or dietary restrictions during the test.
• Wear comfortable clothing, such as loose-fitting shirts.
• Do not apply lotion, moisturizer, or powder to the chest area.
• If the patient needs to bathe, disconnect the cables from the monitor. The monitor should be kept in a dry place and should not get wet, while the electrodes and cables will remain on the patient's chest. After bathing, reconnect the cables to the monitor.
• Do not tamper with the monitor; patients must be responsible for the monitor's condition.
• Do not use electric blankets as they can interfere with the recording.
• Avoid magnets, metal detectors, and high-voltage areas such as power lines.

The examination ends when a notification appears on the monitor screen. The patient should remove the monitor and electrode pads and promptly return the monitor, cables, and notes to the healthcare facility.

Author: Prof. Dr. Ellyza Nasrul Sp. PK(K) (Head of Medical Laboratory and Main Clinic PRAMITA Medan Branch)