Holter Monitor Study: Clinical Protocol and Best Practices

Overview

A Holter monitor is a portable ECG device that records heart rhythms continuously for 24-48 hours or longer. This protocol outlines the proper procedures for device placement, patient instruction, and data collection.

Equipment Required

• Holter monitor device
• Fresh batteries
• ECG electrodes
• Skin preparation materials
• Patient diary forms
• Adhesive tape

Pre-Procedure Protocol

Patient Preparation

1. Verify patient identity and order details
2. Review patient's current medications
3. Explain procedure and monitoring duration
4. Obtain informed consent if required

Skin Preparation

1. Identify correct electrode placement sites
2. Clean sites with alcohol wipes
3. Gently abrade skin if necessary
4. Ensure sites are completely dry

Device Application

Electrode Placement

1. Apply electrodes in prescribed locations:
   • V1 position: 4th intercostal space, right sternal border
   • Modified V5 position: 5th intercostal space, anterior axillary line
   • Modified V3 position: Midway between V1 and V5

Connection Verification

1. Check electrode adhesion
2. Verify signal quality
3. Secure leads with adhesive tape
4. Test device function

Patient Instructions

Essential Guidelines

• Maintain normal daily activities
• Keep device dry
• Complete activity diary
• Note any symptoms
• Avoid electromagnetic interference

Documentation Requirements

• Time and type of activities
• Symptoms experienced
• Medication timing
• Sleep periods

Device Removal and Analysis

Completion Protocol

1. Remove device at scheduled time
2. Document wear duration
3. Download data
4. Process recording
5. Generate preliminary report

Quality Assurance

• Verify minimum 20 hours of readable data
• Check for artifacts
• Validate diary correlations
• Ensure proper documentation

Documentation Requirements

1. Patient demographics
2. Study duration
3. Technical quality
4. Clinical findings
5. Preliminary interpretation