A 37-year-old male asked:
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what do you mean by holter monitor has only one lead but the ecg have 12 leads. how does one lead pick up ischemic changes of the heart rythm. (f/up) previous question?

2 doctor answers
Dr. Scott Hacking
17 years experience Family Medicine
Holter: A holter monitor is primarily used to look for abnormal heart rhythyms, not so much to look for ischemia. Each ECG lead looks from a different angle a the heart while the Holter from only one angle.
Answered on Jul 30, 2016
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Dr. Milton Alvis, jr
40 years experience Preventive Medicine
Lead, in EKG terms,: refers to electrical viewpoint, not the physical number of electrical connections. E.g. the typical single lead Holter connects to two electrodes on the skin plus a third used as an electronic ground to improve signal to noise ratio given the tiny voltages being recorded. Holters are not designed to detect ischemia, only heart rhythm. 12 EKGs can detect signs of ischemia but miss most disease.
Answered on Jul 30, 2016
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Maybe: A holter looks for abnormal cardiac rhythms.

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