ECG Holter - Heart Recording

Yes. Order online, choose 24 hours, 48 hours or 7 days, and the monitor is posted to you free with fitting instructions. You fit it yourself at home, wear it as you go about your normal life, and return it in the prepaid bag. A consultant cardiologist analyses the full recording and your report is emailed within 2 working days of the device arriving back. No referral, no hospital visit and no waiting list. On the NHS, a Holter is arranged through your GP and a cardiology department, typically with a wait of several weeks for the fitting and a further wait for the report.

£199 for a 24-hour recording, £299 for 48 hours and £499 for 7 days, including the device, free delivery both ways and the cardiologist's report. Private hospitals typically charge £250 to £450 for a 24-hour Holter plus a consultation fee of £200 to £300 to request and review it. You do not need to buy a monitor: the device is loaned for the recording period and returned.

Anything to do with heart rhythm. Atrial fibrillation, the commonest serious arrhythmia and a major cause of stroke, which often comes and goes and is missed on a single ECG. Ectopic beats, the skipped or thumping beats most palpitations turn out to be, and how many you have in a day. Fast rhythms such as supraventricular tachycardia. Slow rhythms, pauses and heart block, which cause dizziness and blackouts. And, most usefully, whether the symptoms you note in your diary happen at the same moment as a rhythm change, or whether your heart was beating normally when you felt them.

Whether your coronary arteries are narrowed, whether you have had or are at risk of a heart attack, whether your valves or heart muscle are damaged, or what your blood pressure is doing. Those need different tests: a blood test for cardiovascular risk, an echocardiogram, a CT coronary angiogram or an exercise test. If you have chest pain on exertion, breathlessness lying flat or swollen ankles, see your GP rather than ordering a Holter. If you have chest pain now, call 999.

It depends on how often you get symptoms. If they happen every day, 24 hours is usually enough to catch them. If they happen most days but not every day, 48 hours doubles your chance. If they happen a few times a week or less, choose 7 days: a 24-hour recording of a symptom that occurs weekly will most likely be normal and tell you nothing. For suspected atrial fibrillation that comes and goes, longer is better, because the diagnosis depends on catching an episode. If you are unsure, contact us before ordering.

The pack contains the recorder, electrodes and a step-by-step guide. Clean and dry the skin, attach the electrodes where the guide shows, connect the recorder and start it; it takes a few minutes. Then live normally: work, walk, exercise, sleep with it on. Keep a note of the time and what you felt whenever you have symptoms, because matching your diary to the recording is what makes the report useful. Keep the recorder dry; it must be removed for showers and baths and reattached afterwards.

A consultant cardiologist reviews the entire recording, not a sample of it, and writes the report. It covers your average, minimum and maximum heart rate, any arrhythmias found and how long they lasted, the number of ectopic beats, any pauses or conduction problems, and what was happening on the ECG at the times you noted symptoms, with a clear conclusion. Take it to your GP if anything needs action; the report gives them what they need to refer you to cardiology if required.

The report says what was found and how significant it is. Occasional ectopic beats in a structurally normal heart are common and usually need no treatment beyond reassurance. Atrial fibrillation needs a GP appointment promptly, because treatment to reduce stroke risk may be needed. Significant pauses, heart block or sustained fast rhythms need cardiology referral, which your GP can make with the report in hand. A normal recording during symptoms is also a result: it tells you your heart rhythm is not the cause and points the search elsewhere.

For diagnosis, yes. A smartwatch records a single lead for 30 seconds when you ask it to, which is useful for capturing a suspected atrial fibrillation episode you notice, and some flag irregular rhythms in the background. A Holter records continuously for the whole period, including while you sleep and during symptoms you cannot react to quickly, and the whole trace is read by a specialist rather than an algorithm. If a watch has flagged an irregular rhythm, a Holter is the natural next step to confirm it and quantify it.

Palpitations: a racing, pounding, fluttering or irregular heartbeat, or the sensation of skipped beats, particularly if they last minutes or come with breathlessness. Unexplained dizziness, light-headedness or fainting, especially without warning. Episodes of a very fast or very slow pulse you have noticed or a device has flagged. A history of atrial fibrillation you want to monitor. Or simply persistent worry about your heart rhythm that a normal resting ECG has not settled, because a ten-second ECG only shows what your heart was doing in those ten seconds.

Put the recorder and electrodes back in the original packaging and post it in the prepaid returns bag provided; no label or payment is needed. The recording is downloaded and verified when it arrives, analysed by the cardiologist, and the report is emailed to you within 2 working days of receipt, Monday to Friday excluding public holidays.

If you have a pacemaker or implanted defibrillator, contact us before ordering: recordings can be analysed but need to be flagged. The monitor is for adults aged 18 and over and the recording must be of the person who ordered it, because the report is issued in that name. If you are ordering on behalf of a relative, order in their name and details.