Children's Hospital Colorado

Pediatric Electrocardiogram (EKG), Holter Monitor and Zio Patch 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


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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.

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

An EKG is painless and takes just a few minutes to complete and is the most common test performed in cardiology clinics for children and adults.

During an EKG, our expert 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 their heart rhythm.

EKGs are available on a walk-in basis at many Children’s Hospital Colorado locations if your doctor has placed an order for one. An expert pediatric cardiologist reads all EKGs completed at Children’s Colorado.

Monitoring your child’s heart outside of the hospital

To record your child’s heart activity outside the hospital, ambulatory monitors, external devices that they can carry, are used. Ambulatory monitors allow doctors to look for evidence of heart problems that come and go or that are not apparent when a standard EKG is performed in the clinic or hospital. These monitors works best when your child has frequent symptoms or if there are symptoms your child may not be noticing.

About Holter monitors

The Holter monitor is a device similar to a pediatric electrocardiogram but is portable and worn by a patient away from the hospital or doctor's office. This device can continuously record heart rhythms and electrical activity over a 24- or 48-hour period. When we attach a Holter monitor to a patient, we place five stickers on the child’s chest that are connected to a small recording box about the size of a cell phone that the patient carries or wears for a specified amount of time.

The device records your child’s heart rate and rhythm continuously during various activities or symptoms. During the recording period, you keep a diary of your child's activities and symptoms. The healthcare team at Children’s Colorado then matches the recordings with the activities and symptoms that occurred while your child was wearing the monitor.

About Zio monitors

The Zio monitor is a device like a Holter monitor that continuously records heart rhythms for a longer period: 7 to 14 days. Instead of five small stickers on your child’s chest, it has a wireless patch monitor that is water resistant and can be worn for a full week. The healthcare team at Children’s Colorado then compares the recordings with activities and symptoms that occurred while wearing the monitor.

About event recorders

Event recorders are small devices used by patients over an even longer period (typically one month). Two or three sticky patches (called "electrodes") on the chest connect the wires to the event recorder. When the child or patient has a symptom, they press a button telling the device to record. We also have hand-held monitors without electrodes that can be used in certain situations.

Event recorders should be worn as much as possible every day to increase the chances of recording the child’s heart rhythm when they have symptoms.

Tips for your child’s EKG from other parents

  • Ask your nurse for a liquid adhesive remover to take home to help remove the test stickers.
  • If your child is older, encourage them to take off the stickers themselves. In some cases, this can be less stressful.
  • Once the stickers are off, use baby oil on a cotton ball to remove any excess stickiness.