In this section
Definition of Terms
Appenix 1 - Holter Monitor Event Card
Appenix 2 - Placement of holter monitor electrode
A Holter monitor is a small non-invasive ambulatory, portable ECG machine used to record the heart’s electrical activity in a 24–72 hour period. Holter Monitor’s can provide the following information:
The benefit of ambulatory ECG lies in its ability to examine continuously a patient over an extended period of time, permitting patient ambulatory activity while examining electrocardiographic activity in changing environmental situations (both physical and psychological).
To provide guidance on the management and troubleshooting of Holter Monitors. This clinical guideline applies to children requiring a holter monitor during inpatient admission, children being discharged home with a holter monitor and/or children having a holter monitor applied during an outpatient clinic.
Holter monitor electrodes fall off (see Appendix 2): It is important to reattach as soon as possible, and document the event in the Event’s Card.
Record box is blank: Inform Cardiac Technician during working hours as it may need to be replaced. However if it is noticed after hours keep the dots on, document issue and hand over so Cardiac Technician’s can be informed during hours.
Some children may experience minor skin irritation from the glue on the electrodes. If severe irritation occurs remove the dots and inform the cardiac team. It is rare that anaphylaxis will result, but perform skin, respiratory, circulatory and disability assessment regularly to ensure child is stable. If anaphylaxis occurs employ anaphylaxis guidelines.
Clinical Practice Guidelines: Anaphylaxis
Appendix 2 - Placement of holter monitor electrode
Hegazy, R.A & Lotfy, W.N. (2007) The Value of
Holter Monitoring In The Assessment of Pediatric Patients. Indian Pacing and
Electrophysiology Journal, 7(4):204-214
Uysal R, Bostan OM, Cetinkaya F, Deniz T,
Cil E (2016). Syncope in Children: Is Rhythm Holter Monitoring Necessary?
Journal of Current Pediatrics, 14: 124-128
Yilmaz O, Ciftel M, Ozturk K, Kilic O,
Kahveci H, Laloglu F, Ceylan O (2015). Assessment of heart rate variability in
breath holding children by 24 hour Holter monitoring
Click here to view the Holter Monitor guidleine's evidence table.
Please remember to read the disclaimer.
development of this nursing guideline was coordinated by Annabelle Santos, Clinical Support Nurse, Koala Ward,
and approved by the Nursing Clinical Effectiveness Committee. Updated July 2017.