Since an EKG can be worn during the patient's regular daily activities, it helps the physician correlate symptoms of dizziness, palpitations or black outs. Since the recording covers 24-hours, on a continuous basis, holtor monitoring is more likely to detect an abnormal heart rhythm when compared to the EKG which is less than a minute. It can help evaluate the patient's EKG during episodes of chest pain, during which time there may be telltale changes to suggest ischemia or reduced blood supply to the muscle of the left ventricle.

The chest is cleansed with an alcohol solution to ensure good attachment of the sticky EKG electrodes. Men with hairy chests may require small areas to be shaved. Thin wires are then used to connect the electrodes to a small tape recorder. The tape recorder is secured to the patient's belt or it can be slung over the shoulder and neck with the use of a disposable pouch. The recorder is worn for 24-hours and the patient is encouraged to continue his or her daily activities. To avoid getting wet and damaging the recorder, the patient is not able to shower for the duration of the test. A diary or log is provided to record activity and symptoms. The holter monitor has an internal clock which stamps the time on the EKG strips. This can be used to correlate the heart rhythm with symptoms or complaints.