Our Services

Holter and Event Monitoring

Heart Institute at Children’s Hospital of Pittsburgh of UPMC

When symptoms such as dizziness, fainting, low blood pressure, prolonged fatigue, or palpitations continue to occur without a definitive diagnosis after a resting electrocardiogram (EKG), your child's doctor may request an EKG tracing to be run over a long period of time. Certain arrhythmias (a fast, slow, or irregular heartbeat) which can cause the symptoms may occur only sporadically, or may occur only under certain conditions, such as stress. Arrhythmias of this type are difficult to obtain on an EKG tracing that only runs for a few minutes.

Holter monitoring, a prolonged type of EKG tracing, provides the doctor a better opportunity to capture any abnormal heartbeats or rhythms that may be causing your child's symptoms, especially if they occur frequently.

The Holter monitor test is used to record your child's EKG tracing continuously for a period of 24 hours or longer. You will receive instructions on how long your child will wear the recorder (usually 24 hours, but sometimes longer), how to keep a diary of your child's activities and symptoms during the test, and personal care/activity instructions.

Event monitoring is very similar to Holter monitoring and is often performed for the same reasons. With an event monitor, your child wears EKG electrode patches on his or her chest, and the electrodes are connected by wire leads to a recording device. Unlike the Holter monitor, which records continuously throughout the testing period of 24 to 48 hours, the event monitor does not record until your child feels symptoms and you or your child trigger the monitor to record the EKG tracing at that time. An auto-trigger event monitor may be used to record rhythms when symptoms are rare or suspected to occur during sleep. The auto-trigger event monitor automatically records rhythm events and can be manually activated if your child experiences symptoms.

When your child feels one or more symptoms, such as chest pain, dizziness, or palpitations, one of you will push a button on the event monitor recorder. Some monitors have a feature called "memory loop recording," in which the monitor can include a recording of a short period of time prior to the moment you triggered the recording and afterwards. This feature can help your child's doctor determine more details about the possible change in your child's EKG at the time the symptoms started, and what was happening with your child's EKG just before you or your child triggered the recorder. Other monitors, called "post-event recorders," simply start recording the EKG from the moment you trigger it.

After symptoms are experienced and recorded, you send the recording to your child's doctor or to a central monitoring center. You will also keep a diary of your child's symptoms and corresponding activities, just as with the Holter monitoring procedure.

Some reasons for your child's doctor to request a Holter or event monitor procedure are to:

  • evaluate chest pain
  • evaluate other signs and symptoms which may be heart-related, such as fatigue, shortness of breath, dizziness, or fainting
  • help identify irregular beats
  • further evaluate arrhythmias noted on a resting EKG

Depending on the results of the Holter monitor, additional tests or procedures may be scheduled to gather further diagnostic information.

View the patient procedure sheet about Holter Monitoring at Children’s Hospital of Pittsburgh of UPMC.

Last Update
August 21, 2012
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Last Update
August 21, 2012