Ambulatory ECG Monitoring & 12-lead ECG
Placement
Part 1: Ambulatory ECG Monitoring
Introduction
Ambulatory ECG monitoring is a specialist cardiovascular
investigation that records heart rate and rhythm over an extended
period during normal daily activities (including rest and sleep).
Different from a resting ECG, which records for ~10 seconds at rest.
Device often called a Holter monitor — battery-powered,
wearable, usually attached to 2–3 leads, sometimes up to 12.
Study Duration Types
Monitoring durations: commonly 24 hours, 72 hours, or 7 days,
extendable up to 14 days.
Longer duration → higher chance of detecting arrhythmias.
Also called 24-hour, 72-hour, or 7-day ‘tapes’.
Clinical Indications
Evaluate patients with intermittent symptoms not seen on resting
ECG.
Common indications:
o Syncope (transient loss of consciousness)
o Chest pain
o Palpitations
o Dizziness
o Shortness of breath
Evaluation of known arrhythmias or pacemaker function.
Important in diagnosing paroxysmal atrial fibrillation (AF), which
can be intermittent and symptomatic.
Used also to monitor treatment efficacy, e.g., after catheter
ablation.
How to Request an Ambulatory ECG
Include in your referral:
Patient details: Name, DOB, ID/Hospital number, address
Indication (e.g., “palpitations”)
Relevant medical and medication history
Recent 12-lead resting ECG
Missing info may delay the request
Placement
Part 1: Ambulatory ECG Monitoring
Introduction
Ambulatory ECG monitoring is a specialist cardiovascular
investigation that records heart rate and rhythm over an extended
period during normal daily activities (including rest and sleep).
Different from a resting ECG, which records for ~10 seconds at rest.
Device often called a Holter monitor — battery-powered,
wearable, usually attached to 2–3 leads, sometimes up to 12.
Study Duration Types
Monitoring durations: commonly 24 hours, 72 hours, or 7 days,
extendable up to 14 days.
Longer duration → higher chance of detecting arrhythmias.
Also called 24-hour, 72-hour, or 7-day ‘tapes’.
Clinical Indications
Evaluate patients with intermittent symptoms not seen on resting
ECG.
Common indications:
o Syncope (transient loss of consciousness)
o Chest pain
o Palpitations
o Dizziness
o Shortness of breath
Evaluation of known arrhythmias or pacemaker function.
Important in diagnosing paroxysmal atrial fibrillation (AF), which
can be intermittent and symptomatic.
Used also to monitor treatment efficacy, e.g., after catheter
ablation.
How to Request an Ambulatory ECG
Include in your referral:
Patient details: Name, DOB, ID/Hospital number, address
Indication (e.g., “palpitations”)
Relevant medical and medication history
Recent 12-lead resting ECG
Missing info may delay the request
