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24 Hour Ambulatory ECG (Holter) Monitor

What is a Holter Monitor?

A Holter Monitor is a portable electrocardiogram (ECG) used to continuously monitor a patient's heart for a duration of up to 24 hours

Why is a Holter Monitor Test Performed?

A Holter Monitor is used to assess the rhythm of the heart as the patient goes about their normal daily activities. A Holter Monitor is often used to assess whether a rhythm disturbance is responsible for a patient’s symptoms.

It can also be used to assess the effectiveness of medications on the heart rate and / or heart rhythm.

Preparation for Holter Monitor Use

On the day of the test we recommend the following

  • There is no specific dietary preparation for the test
  • Bath or shower before your appointment as you will not be able to do so while the monitor is on.
  • Please do not use body lotion on your chest - this may interfere with the adhesive electrodes.
  • ECG patterns and some of the body’s responses to exercise can be affected by various medications, so please bring a complete list of your medications to your appointment.
  • You will be asked permission to perform the test

What to Wear for the Holter Monitor

When you enter the test room patients are required to:

  • Undress to the waist so wear a two-piece outfit
  • Manipulation of bras (on and off) during the monitoring period risks dislodging electrodes and / or leads, therefore women are asked to commit to either wearing no bra for the monitoring period, or wearing a bra for the whole 24 hours without removing it.  If “bra-on” is your preference, please wear your most comfortable one.

Holter Monitor Test Connections

Patients are prepared for the test by having:

  • Electrode sites on the chest are thoroughly cleansed with alcohol wipes
  • Some men require a small amount of shaving to ensure good electrical contact between the electrode and skin which can be hampered by bodily movement during the test
  • Adhesive electrodes are then attached to the chest
  • The electrodes are connected to leads
  • The leads provide the signals for the ECG to record
  • These leads are then connected to a small monitor (about 8cm x 5cm x 2cm), which is then worn around the neck.

What happens during the Holter Monitor period?

The monitor will beep 3 times when the Technician hooks the patient up.

The monitor will beep 1 more time about 10 minutes later.  You may or may not hear this beep, depending on the surrounding noise level of where you are.  Do not be concerned if you hear it or don’t hear it.

The monitor has a green light which flashes at fairly random intervals throughout the monitoring period.  It does not represent your heart’s rhythm.  Patients often first notice it flashing at night as they prepare for bed.  Don’t be concerned - this is normal.

If you have any difficulties with the equipment, please notify the office.

If you experience any symptoms, (even if they are brief or slight) you should make a note of the symptoms and time either on a special diary given to you or on your own piece of paper.


When wearing a Holter Monitor, please do not:

  • Tamper with the leads or battery as this may erase data from the device.
  • Bath / swim / shower with the monitor on - you cannot get the monitor wet.
  • Sleep on an electric blanket which is switched on. This will interfere with the recording.  If desired, it is okay to turn an electric blanket on to warm up the bed before hopping in - as long as is turned off before you get in.
  • Use any device which puts electrical current through your body during the monitoring period as this may erase data.  This includes devices such as a TENS or Interferential machine, or a “Circulation Booster” (such as the one promoted by Dawn Fraser).

Booking a Holter Monitor Test

You must attend on 2 consecutive days for this test. Patients are required to return at the same time the next day, or a little earlier. Please check the time with the Technician

Day One

This is when the Holter Monitor is applied. This usually takes 15 to 30 minutes.

Day Two

The next day patients return to have the Holter Monitor removed. This usually takes 10 to 15 minutes.

Locations & Directions

Southern Heart Centre

Suite 18 Level 4, St George Private Hospital, 1 South St, Kogarah, NSW 2217

Southern Cardiology

74 Kareena Rd, Miranda, NSW 2228

  • Royal Australasian College of Physicians
  • Cardiac Society of Australia & New Zealand
  • Fellow of the Cardiac Society of Australia and New Zealand
  • The Australian Council On Healthcare Standards
  • St George's Hospital Community Health Services
  • St George Private Hospital
  • Ramsay Health Care