Holter examination for cardiac arrhythmia

Holter examination for cardiac arrhythmias, an accelerated or too slow heart rate. Sometimes the heart does not go the way we want: the rhythm is disturbed and this can be felt as palpitations and sometimes even chest pain. An ECG or ECG does not always provide the correct diagnosis, especially when the symptoms occur irregularly. With a Holter examination, a 24-hour ECG can be made so that the patient can simply go home. Sometimes it even takes 48 hours. There are a number of things to pay attention to during a Holter examination.

What is a holter?

A holter, also called a holter box, is a device with which a 24-hour (sometimes 48-hour) ECG can be made. An ECG is a heart film on which the doctor can view the electrical activity of the heart. The heartbeat (the pumping of the heart) happens in a certain order that is controlled by electrical impulses. These impulses follow a fixed pattern. This pattern can be determined with an ECG.

Why a Holter examination?

A Holter examination is performed because you have cardiac arrhythmias, a heartbeat that is too fast or too slow. Sometimes this occurs in attacks. This makes it difficult to capture the abnormal pattern during a normal ECG. We often see that the heart does its work normally during an ECG and shows no abnormalities. With a 24-hour ECG the patient can go home and it is much easier to detect disorders.

Connecting the holter box

Connecting the Holter box is done in the hospital, usually in the cardiology department. You must bare your upper body, women may keep their bra on. Men sometimes need to shave off chest hair and/or belly hair. The skin is lightly sanded with sandpaper. This may feel a bit annoying, but it is necessary to remove dead skin cells and fat. Four to seven electrodes are then attached to the body. These are stickers that adhere to the skin. There is a conductive gel between the skin and the electrodes. The Holter box is then connected to the electrodes by means of wires. Each sticker has a color that matches the end of a wire. If one or more straps ever come loose at home, attach them to the correct color using the click system.
The holter box is equipped with batteries and the hospital ensures that these batteries are full and last at least 24 hours. Sometimes you have to wear the holter box for 48 hours. The batteries are also adapted to this. The box is attached to your belt or placed in a bag that is worn around the neck or shoulder. The cables are kept out of the way as much as possible.

Do not shower or swim

The box is not water resistant. This means no showering or swimming while wearing this. It is not possible to temporarily disconnect the box and take a shower or swim, because the clearest possible picture must be formed during these 24 or 48 hours. It is advisable to continue doing normal things such as working, exercising or other activities that you normally do without a holter box.

Keep a diary

Every patient who undergoes a Holter examination keeps a diary. It must be noted at what time which activity is performed. Activities include sleeping, eating, walking, exercising, working, emotions, cycling, etc. It must also be noted whether complaints occurred during these activities, such as chest pain, shortness of breath, dizziness, nausea, palpitations, etc. Sometimes the patient must click on the blue Press the button when complaints arise. Sometimes it is even possible to record complaints using the built-in voice recorder. When this option is available, it must always be reported by the doctor. No unsolicited audio recordings may be made.


The gel or stickers can cause complaints of redness, itching and bumps. This is very annoying and the tendency to scratch can be strong. Try to scratch around the stickers a little and do not pull on the threads or the stickers. When the stickers are removed, the skin may look very red and may remain itchy for some time. Blisters or blisters can also develop later. Use a soothing cream or ointment without perfume and try to leave the skin alone as much as possible. The rash will disappear on its own.

Reimbursement and deductible

A holter examination falls under your own risk. Depending on how high the deductible is and what is left of it, you sometimes have to pay for part of the research. Everything that falls outside the deductible is reimbursed by basic health insurance. However, a referral from the GP or indication from a doctor is always required to receive this reimbursement. A Holter examination at your own request without a medical indication will therefore not be reimbursed.

The outcome

In most cases, you will receive the results of the test one to three weeks after the Holter test. It takes some time to read and assess the data. Often multiple tests are required, such as a cycling test and an ultrasound of the heart, and these data are compared with each other.

read more

  • Heart film or ECG
  • Feeling the heart beating in your throat or neck
  • Heart skips a beat, cause and effect
  • Event recorder for cardiac arrhythmia
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