Holter and Event Monitoring

What is a Holter Monitor Test?

When your child's symptoms — such as dizziness, fainting, low blood pressure, prolonged fatigue, or heart palpitations — continue to occur without a clear diagnosis after a resting EKG (electrocardiogram), the doctor may want to run EKG tracing over a longer time.

Certain arrhythmias (a fast, slow, or irregular heartbeat) that can cause these symptoms may only occur sporadically or under certain conditions such as stress. This makes it hard to obtain data on these types of arrhythmias during an EKG tracing that only runs for a few minutes.

Holter monitoring — a prolonged type of EKG tracing — gives doctors a better chance to capture any abnormal heartbeats or rhythms that may be causing your child's symptoms, especially if they occur often.

The Holter monitor test records your child's EKG tracing, non-stop, for 24 hours or longer.

The care team at the Heart Institute at Children’s Hospital of Pittsburgh of UPMC will give you instructions on:

  • How long your child will wear the recorder (24 hours in most cases, but sometimes longer).
  • How to keep a diary of your child's activities and symptoms during the test.
  • Personal care and other tips.

What is Event Monitoring?

Event monitoring is much like Holter monitoring. Doctors often order event testing for the same reasons.

Unlike the Holter monitor — which records the entire testing period of 24 to 48 hours without stopping — the event monitor does not record until your child feels symptoms. You or your child must trigger the monitor to record the EKG tracing at the time the symptoms occur.

How event monitoring works

With an event monitor, your child wears EKG electrode patches on his or her chest. Wire leads connect the electrodes to a recording device.

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 event monitors have auto-trigger and "memory loop recording" features.

  • An auto-trigger event monitor records rhythms when your child's symptoms only occur rarely or during sleep. The auto-trigger event monitor automatically records rhythm events, but also allows your child to trigger the device manually when he or she feels symptoms.
  • Memory loop recording includes a short recording right before and after the moment you trigger the device. This feature can help your child's doctor learn details about the possible change in your child's EKG when 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," start recording the EKG from the moment you trigger it.

After your child records his or her symptoms, you send the recording to the 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 test.

Why Might My Child Need Holter or Event Monitoring?

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

  • Assess chest pain.
  • Check other signs and symptoms that may be heart-related — such as fatigue, shortness of breath, dizziness, or fainting.
  • Help identify irregular heartbeats.
  • Further assess arrhythmias noted on a resting EKG.

Depending on the results of the Holter monitor test, your child's doctor may schedule other tests or procedures to help confirm a diagnosis.

Learn More About Holter and Event Monitoring

To learn more about Holter and event monitoring tests at Children's: