Holter Monitoring for Children

May 09, 2019

Holter monitoring is a way to continuously check the electrical activity of the heart. Your child will wear a small device called a Holter monitor for at least 24 to 48 hours. The monitor is attached to your child's chest with adhesive patches called electrodes. The device continuously records your child's heart rate and rhythm during this time, even while away from the healthcare provider's office. This is different from electrocardiography (ECG). An ECG records the heart rhythm for only a few seconds.

Your child's regular healthcare provider will likely refer you to a pediatric cardiologist for this test. This is a healthcare provider with special training to diagnose and treat heart problems in children.

Some reasons for your child's Holter monitoring may include:

  • Chest pain
  • Other signs and symptoms that may be from a heart problem, such as tiredness, shortness of breath, dizziness, or fainting
  • Irregular heartbeats
  • ECG that was not normal

There is minimal risk with Holter monitoring. In rare cases, a child can have an allergic reaction to the adhesive in the electrodes attached to the chest.

Explain the test to your child. Your child does not need to do anything else to get ready.

Holter monitoring is done as follows:

  • The healthcare provider places small plastic patches (electrodes) on your child's chest. Then they attach the electrodes to the monitor with lead wires.
  • The monitor is small and portable. It may be worn over the shoulder, in a special pouch, or clipped to a belt or pocket.
  • You will be given instructions on:
    • How to keep the electrodes attached to your child's skin
    • How to check the monitor for problems
    • When to call the healthcare provider’s office for help
    • How to keep a record with the date and time of day of any changes in activity and symptoms
    • What to avoid, such as getting the device wet
  • Once your child is hooked up to the monitor and you have been given instructions, your child can go back to their usual activities.

Once the monitoring is complete, you or your healthcare provider will remove the electrodes and monitor from your child. The provider will look at the information from the monitor and talk with you about the results.

Depending on the results of the monitoring, your child’s provider may order other tests.

Before you agree to the test or the procedure for your child make sure you know:

  • The name of the test or procedure
  • The reason your child is having the test or procedure
  • What results to expect and what they mean
  • The risks and benefits of the test or procedure
  • When and where your child is to have the test or procedure
  • Who will do the procedure and what that person’s qualifications are
  • What would happen if your child did not have the test or procedure
  • Any alternative tests or procedures to think about
  • When and how you will get the results
  • Who to call after the test or procedure if you have questions or your child has problems
  • How much you will have to pay for the test or procedure


May 09, 2019


The Value of Holder monitoring in the assessment of pediatric patients. Hegazy, RA., Indian Pacing Electrophysiology Journal (2007)7(4):204-214

Reviewed By:  

Steven Kang MD,Paula Goode RN BSN MSN,Lu Cunningham