Children's Hospital Colorado

Pediatric Electrocardiogram (EKG), Holter Monitor and Event Recorder Tests

We are one of the largest programs in the country treating patients with heart problems from before birth through adulthood, with exceptional outcomes.

Best Children's Hospital by U.S. News & World Report Cardiology 2021-2 Badge

Getting a pediatric electrocardiogram

A pediatric electrocardiogram (called an EKG or ECG for short) is a non-invasive heart test that graphically records the electrical activity of the heart in kids.

A provider hooks up sensors for an EKG for a baby

This test gives doctors information about the rhythm of the heart and whether the electrical activity is too fast, slow or irregular and if the heart’s chambers are too large or overworked. 

The pediatric electrocardiogram is painless and takes just a few minutes to complete. This is the most common test performed in cardiology clinics.

Our technician will place a series of stickers on your child’s arms, legs and chest. Small wires connected to those patches lead to a machine that records the necessary information. 

Parent tip from mom, Kellie:

"This is by far the easiest and quickest test you will encounter in the cardiology clinic. A wonderful thing about this test for my child is that the stickers they use do not stick so hard that they hurt when they come off. The test is quick and simple, and besides the many wires hanging off the chest, it is really not scary for your child. Afterwards, you might suggest that your child take off the stickers by him or herself; for some kids this makes a big difference."

Monitoring your child's heart outside of the hospital

Ambulatory monitoring (using Holter Monitors and event recorders) is done to record a patient's EKG for a prolonged period of time, on an outpatient basis. The purpose of ambulatory monitoring is to look for evidence of heart problems that come and go or that are not apparent when a standard EKG is performed.

About a Holter Monitor

The Holter Monitor is a device similar to a pediatric electrocardiogram in that is portable and worn by a patient over a period of time away from the hospital or doctor's office. This device can continuously record heart rhythms and electrical activity onto a disk over a 24- or 48-hour period. Stickers are placed on the child’s chest and connected to a small recording box about the size of a cell phone that the patient carries or wears for the specified amount of time.

The test records your child’s heart rate and rhythm during various activities or symptoms, and you keep a diary of your child's activities and symptoms during the recording period. The staff at Children’s Hospital Colorado then matches the recordings with the activities and symptoms that occurred while your child was wearing the monitor. This monitor works best when your child has frequent symptoms or if there are symptoms your child may not be noticing.

About an Event Recorder

Event recorders are small devices used by patients over a longer period (typically one month). Two or three sticky patches (called "electrodes") on the chest connect the wires to the event recorder. We also have hand-held monitors (without electrodes) that can be used in certain situations. The intent is for most event recorders to be worn as much as possible every day to increase the chances of recording the child’s heart rhythm when he or she has symptoms. 

Parent tip from mom, Jen:

"The stickers for the Holter Monitor and Event Recorder tests can sometimes be difficult to remove because they are intended to stay on for a longer period of time. Ask your nurse for a liquid adhesive remover to take home with you that is safe for the skin. An older child might prefer to take the stickers off by himself—sometimes this is less stressful and painful than having you do it for them. After the stickers are off, try baby oil on a cotton ball to remove the excess stickiness."