What is included in a Holter system?

A modern Holter System consists of a portable recorder used for continuous monitoring of electrical signals of the heart for at least 24 hours or even more. This extended data collection is useful for identifying occassional cardiac abnormalities that would be difficult to be detected within a shorter period of time. The monitoring is carried out via patient electrodes attached to the chest. The number and the position of the electrodes varies by models, but most Holter Systems operate with 3 channels. After a monitoring session, the collected ECG data are uploaded to a PC to be analised by a software.


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History of Holter recorder systems

The development of the Holter Sytems has a long history. The ECG Holter equipment was invented by the biophysicist Norman J. Holter, who is nowadays called the ’Father’ of the Holter systems. It was him, who realised that an ambulatory ECG documentation would be required by medical practices, and this recognition encouraged him to make experiments in this field. The first Holter System was invented in 1947. It was an enormous apparatus which had only a single channel and consisted of heavy batteries and an ECG radio transmitter, therefore it weighted approximately 38,5 kilogramms. By 1952 this unit was re-designed and the new device – with its amplifier and transmitter – weighted only a bit more than 1 kilogramm. The spread of the transistors made the downsize of the original Holter System possible and the previously applied radio transmission was replaced by a magnetic tape recorder. In this new Holter System data was retrieved and analised by a tape playback system, but this process brought about the distortion of the collected ECG data.

Medical use

The clinical use of the Holter monitoring systems started in the early 1960’s. The original aim of the Holter System was to identify the different classes of cardiac abnormalities, however, these systems was sophisticated later to detect ST displacement, to collect HRV data, to make various types of ECG analyses and to check the effect of drugs against heart disease out.

We witnessed an advancement in memory technology in the 1980’s, but despite the progress, these Holter Systems continoued to compress ECG data, which meant a threat to the appropriate evaluation of the collected information.

This threat seemed to have passed in the early 1990’s, when technology progress led to the development of smaller and cheaper hard drives with more than a 20 megabyte storage facility. This fact made no-compression ECG storage possible, which is a very important feature of modern ECG Holter Systems.