If there is some unusual electrical pattern present, we follow the EKG with a 24 Hour Holter Monitor. This device is a little box (see picture) that looks like a portable cassette or CD player and the patient wears this with 3 EKG leads hooked up, for 24 hours. We essentially expand the 10 seconds that it takes to do an EKG to 86,400 seconds (24 hrs) allowing us a time period over 8000 times longer to look for that run of extra beats or that elusive rhythm. If the patient notices the abnormal symptoms that he had been experiencing, the he simply presses a button on the machine and it makes a permanent recording of what his heart was doing at the point in time. As you can see from the photo, this is not a huge piece of equipment.