Heart rhythm monitoring is used when Dr Giardini needs to record your child's heart rhythm over a longer period than a standard ECG. A resting ECG captures only a few seconds of the heart's electrical activity, which means that rhythm disturbances occurring at other times during the day or night can easily be missed. Longer monitoring increases the chances of detecting an abnormal rhythm that may happen randomly or in response to particular activities.

The most common form of extended monitoring is the 24-hour Holter monitor. This is a small, lightweight recording device, roughly the size of a mobile phone, that is attached by thin wires to a few adhesive stickers placed on your child's chest. The monitor is worn continuously for a full day and night, recording every heartbeat throughout that period. Your child can carry on with all normal daily activities, including school and play, while wearing the device. It is important to keep the stickers firmly in place, and clear instructions will be given on how to reattach them if they come loose. The monitor is not waterproof, so your child should avoid baths or showers while it is being worn.

A symptom diary is provided alongside the monitor, and filling it in carefully is a key part of the test. You will be asked to note the exact time whenever your child experiences any symptoms such as palpitations, dizziness, chest pain or fainting. Dr Giardini can then compare the heart rhythm recording at those precise moments with the symptoms reported, which is often the most valuable part of the investigation. The more accurately the diary is completed, the more useful the results will be.

When monitoring for longer than 24 hours is needed, event recorders offer an alternative. External patch monitors, such as the Zio patch, are small adhesive devices that stick directly onto the chest without any wires, making them comfortable and discreet to wear. These can record continuously for three to seven days, capturing rhythm disturbances that occur less frequently. For children who need monitoring over weeks or even months, an implantable loop recorder may be recommended. This is a tiny device, smaller than a USB stick, that is placed just beneath the skin of the chest during a short, minor procedure under local or light general anaesthetic. Once in place it records the heart rhythm automatically and can also be activated by the patient when symptoms occur.

All forms of heart rhythm monitoring are safe and well tolerated. Results are analysed by Dr Giardini personally and discussed with you at a follow-up appointment. If you have any concerns about your child's heart rhythm or would like to arrange monitoring, please do not hesitate to contact Dr Giardini's team.