Roles of Nurses in Caring for Patients with Cardiac Arrhythmias by Installing a Holter Monitor: A Case Study

Main Article Content

Nattira Chanviavit
Umawarat Sarisai
Jantra Keawpugdee


  Cardiac arrhythmia is a condition in which the heart rate is irregular; the heart rate is faster or slower than normal unsuitable for the body’s condition at that time. This feature may also include abnormal heart rhythms.Checking for abnormal heart rhythms with an electrocardiogram (ECG)is the easiest and fastest way to examine with a simple procedure that provides preliminary answers. However, for those with occasional or short-term arrhythmias, the arrhythmia may not be detected during their visit.Consequently,a 24-hour continuous ECG recorder with a Holter monitor has been used to detect more abnormalities in the ECG. This article aims to explain the roles of nurses in assessing, caring, and providing nursing care to patients who need continuous ECG recording 24 hours before, during, and after the Holter monitor installation. Accurate nursing care tailored to each patient will enable him/her to receive continuous and effectivecare. The patients can behave correctly per suggestions, leading to aquick and accurate diagnosis.
Keywords: Cardiac arrhythmia, Holter monitor, Role of nurses       

Article Details

How to Cite
Chanviavit N, Sarisai U, Keawpugdee J. Roles of Nurses in Caring for Patients with Cardiac Arrhythmias by Installing a Holter Monitor: A Case Study. Nurs Res Inno J [Internet]. 2024 Apr. 19 [cited 2024 Jun. 14];30(1). Available from:
Academic Articles


Bundasak TP, Thiankumsri KP,Sittisongkram ST. Atrial fibrillation. J Prapokklao Hosp Clin Med Educat Center.2017;34(4):341-9.

Nicholas RJ, Clare JT, Richard H, Louise B, Barbara C.Screening for atrial fibrillation: a call for evidence. Eur Heart J. 2020;41(10):1075–85.

Nilayon D. Cardio embolic stroke in non-valvular atrial fibrillation.JournalofThePoliceNurse.2020;12(2):447-55. (in Thai)

Johnson&JohnsonMed Tech.Atrial fibrillation projected to affect 72 million people in Asia Pacific by 2050 according to new report from Biosense Webster; 2019[cited 2023 Jan 25]. Available from: /en-IN/news-events/atrial-fibrillation-projected-affect-72-million-people-asia-pacific2050-according-new

Mubarik A, Muhammad A. Holter monitor. National Library of Medicine;2022 [cited2023 Jan 25].Available from: https://

Healthcare Made Practical Global Learning Network.Biotricity receives fed 510 (k) clearance for its biotres cardiac monitoring device; 2022 [cited 2023 Jan 25].Available from:

Catherine MO, Rick AN, Robert OB, Blasé AC, Gentile F, et al. ACC/AHA Guideline for the management of patients with valvular heart disease: executive summary:A report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. J Am Coll Cardiol. 2021;77(4): e25-197.

Ngamtrairai P. Detection of atrial fibrillation by holter monitoring in elderly patients with ischemic stroke.J Thai Stroke Soc. 2021;20(1):5-14.

Cleveland Clinic. Holter monitor; 2023 [cite 2023 July 24]. Available from:

MartinP. Holter monitoring; 2023 [cited 2023 Jan 25].Available from: = IwAR1OxoaMzlO910dlMvvu_4H JOuCSninSpNU_io7MQHXKRWrSku_HMWOs5NI

Physicians ancillary systems. Holter monitor instructions;2020 [cited 2023 Jan 25]. Available from: https:// /holter-monitor-instructions/

Dale KM.How to wear a holter monitor; 2023 [cite 2023Jan 25]. Available from:


Kliangprom JA, Putivanit SU. Prevention of skin breakdown in the older person. The Southern College Network Journal of Nursing and Public Health.2017;4(3):249-58. (in Thai)

The Heart Clinic. What to avoid while wearing a holter monitor; 2023 [cited 2023 Jan 25]. Available from:https:// www.

Heart Hospital. Ambulatory monitoring or holter monitor;2024[cited 2023 Jan 25]. Available from: https:// www. /en/medical-service/ambulatory-monitoring-or-holter-monitor

DaomaneeP. Nursing care of cardiac arrhythmia patients received holter monitoring: 2 cases studies; 2020 [cite2023 Jan 25]. Available from: aee7.pdf (in Thai)

Med Park Hospital.Holter monitoring; 2023 [cited 2023 Jan 25]. Available from: content/holter-monitor (in Thai)

Martinez K. Everything you need to know about inflammation; 2023 [cite 2023 Jan 25]. Available from:https://

Singkongsin S,Sumpuntarut N, Chuentrakul S. The effect of cold cream applied over the skin to prevent pressure sore among bed ridden patients in intensive care unit at Chonprathan hospital. Thai Journal of Nursing. 2019;68(4): 49-55. (in Thai)

Fogoros RN. Holter monitor test: everything to know;2022 [cited 2023 July 19]. Available from: https://www. /holter-monitor-study4172395

Hersh E.What can you do to prevent fainting; 2020 [cited 2023 July 19].Available from: how-to-prevent-fainting

Pobpad.Propranolol; 2022.[cite 2023 Jan 25]Available from: (in Thai)

Ahmed M. Holter monitor explained by a cardiologist;2016 [cited 2023 July 19]. Available from: /articles/holter-monitors-explained-by-acardiologist/?fbclid=IwAR2yy2mkxgiu5zEnKPJN7sCj 0Ez7LELW5gG1lcMVDD-CO_GrHDMHcPLKSlI

Mayo clinic. Holter monitor; 2023 [cited 2023 July 19].Available from: wenr VMhcgYcWtRx5KliZWxX1dg

PensriL,Ua-kit N.Care of patients with permanent cardiac pacemaker: nurse’s roles. Ramathibodi Nursing Journal.2019;25 (3):255-69.(in Thai)