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Holter Monitoring in Children

What is Holter monitoring?

Holter monitoring is a way to continuously check the electrical activity of the heart. Your child will wear a small device called a Holter monitor for at least 24 to 48 hours. The device constantly checks your child's heart during this time, even while away from the doctor's office. This is different from electrocardiography (ECG). ECG checks the heart for only a few minutes.

Your child's regular healthcare provider will likely refer you to a pediatric cardiologist for this test. This is a doctor with special training to diagnose and treat heart problems in children.

Why might my child need Holter monitoring?

Some reasons for your child's Holter monitoring are:

  • Chest pain
  • Other signs and symptoms that may be from a heart problem, such as tiredness, shortness of breath, dizziness, or fainting
  • Irregular heartbeats
  • Abnormal ECG 

What are the risks of Holter monitoring?

There are no risks of Holter monitoring.

How do I get my child ready for Holter monitoring?

Explain the test to your child. Your child does not need to do anything else to get ready.

What happens during Holter monitoring?

Holter monitoring is done as follows:

  • The healthcare provider places small plastic patches (electrodes) on your child's chest. Then he or she attaches the electrodes to the monitor with lead wires.
  • The monitor is small and portable. It may be worn over the shoulder, in a special pouch, or clipped to a belt or pocket.
  • You will be given instructions on:
    • How to keep the electrodes attached to your child's skin
    • How to check the monitor for problems
    • When to call the healthcare provider’s office for help
    • How to keep a record with the date and time of day of any changes in activity and symptoms
    • What to avoid
  • Once your child has been hooked up to the monitor and you have been given instructions, he or she will go back to his or her usual activities.

What happens after Holter monitoring?

Once the monitoring is complete, you or your healthcare provider will remove the electrodes and monitor from your child. The provider will look at the information from the monitor.

Depending on the results of the monitoring, your child’s provider may order other tests.

Next steps

Before you agree to the test or the procedure for your child make sure you know:

  • The name of the test or procedure
  • The reason your child is having the test or procedure
  • What results to expect and what they mean
  • The risks and benefits of the test or procedure
  • When and where your child is to have the test or procedure
  • Who will do the procedure and what that person’s qualifications are
  • What would happen if your child did not have the test or procedure
  • Any alternative tests or procedures to think about
  • When and how will you get the results
  • Who to call after the test or procedure if you have questions or your child has problems
  • How much will you have to pay for the test or procedure

Medical Reviewers:

  • Bass, Pat F., III, MD, MPH
  • Gandelman, Glenn, MD, MPH