Long-term ECG

What's this?

A long-term EKG is the permanent recording of an electrocardiogram, which usually lasts 24 hours. An EKG measures electrical potentials using electrodes that are attached to the skin at various points on the body. The measurements through the electrodes lead to a cassette-like recorder that is hung around the neck with a tape.

The measurement takes place permanently without the patient noticing anything. In contrast to long-term blood pressure, no cuff inflates and the measurement is not noticeable. As a result, sleep is not disturbed by the recorder or the electrodes at night. During the 24 hours a Minutes keptwhat activities were performed at a specific time. On the basis of this, the doctor can assess which everyday situation has an influence on cardiac activity. The measurement usually starts early in the morning in cardiac practice. The device is delivered to the practice around 24 hours later. It then takes a few days to weeks before the doctor Results evaluated and made a diagnosis. On this basis, further examinations or therapies can be discussed.

Every single heartbeat through the heart muscle cells is triggered by electrical impulses. The heart has an excitation conduction system for this numerous nerve cellsthat extends from the left atrium through the entire heart. Due to its own excitation system, the heart works independently and does not need a permanent drive from the brain. It can only be influenced in strength, speed and excitability.

There are electrical voltage changes between excited and non-excited areas of the heart, which can be measured on the surface of the skin. At least two electrodes are required to measure the signals. Depending on the change in voltage, it can be understood how the electrical excitation spreads in the heart. The location and spread of the excitation can be assessed more precisely using up to six electrodes.

With the long-term ECG, unlike in the clinical routine, the recording is made over 24 hours in order to be able to examine the cardiac excitation in different phases of everyday life outside the practice.

Who needs a long-term EKG?

A long-term EKG is especially useful for one Suspected arrhythmia carried out. In routine clinical diagnostics, ECG examinations are often used, but only for a few seconds to minutes. Many cardiac arrhythmias can be pronounced and clinically relevant, but are not noticeable in a short examination. Often times, patients notice symptoms such as Palpitationswhich occurs only rarely and is therefore very likely not to be seen in a conventional EKG.

The most important indications for which a long-term ECG is recommended are Racing heart, Palpitations and Circulatory problems up to fainting spells, also "Syncope" called. The long-term ECG can be used to determine exactly what type of cardiac arrhythmia is occurring and when and how often it occurs. Even patients with known heart disease A long-term EKG is recommended to assess your current cardiac arrhythmia.

Theoretically, a long-term ECG can also be used to determine a permanent circulatory disorder. However, this plays a rather subordinate role for clinical diagnostics.

Please also read our page Recognizing arrhythmias.

Can I take a shower with it?

With a long-term ECG you shouldn't take a shower. The shower itself does not influence the possibilities of the ECG recording, however the measuring device and the electrodes glued to the upper body must not get wet.

In contrast to the long-term blood pressure monitor, the long-term ECG cannot be pulled out for a short time as the measurement is permanent. If the device is removed while showering, part of the measurement is missing. In addition, there is a risk that the water could detach the electrodes on the upper body. It is recommended to shower before starting the long-term ECG measurement and to keep the 24 hours without close contact with water. Of course, the essentials can be cleaned with a sponge. Only the parts involved in the measurement need to remain dry.

Can you work with it?

A normal everyday work can and should be performed during the long-term ECG recording. It is important for assessing cardiac activityto live a normal everyday life so as not to distort the results. However, hectic, abrupt and particularly physically demanding work must be carried out with care.

During heavy work, care must be taken not to tear off the loosely glued electrodes. Strong physical work can also change the recording by influencing the heart. This mainly includes manual work, for example on a construction site.

Vibrating work can also influence the function of the device. Drills, jackhammers and the like falsify the results. In addition to work equipment, everyday objects such as an electric razor or a hair dryer can have negative effects on the recording.

The recorder does not present any obstacles during office work. The measurements remain unnoticed by the patient and nothing stands in the way of normal work within the 24 hours.

Can I do sports with a long-term EKG?

In general, during a long-term EKG measurement is one sporting activity possible. If the exercise of sport is part of everyday life for the patient, sport can also be practiced on this day. Please note, however, that the electrodes are connected to the recorder via cables and Care must be taken not to tear anything off with jerky movements. Since showering should be avoided during the 24 hours, it must be decided by the patient whether exercise without the possibility of washing on the day makes sense or not. If you sweat too much on your chest, the electrodes may become detached.

For people who seldom do sport in everyday life, strenuous exercise can falsify the results. Half an hour of endurance training can influence cardiac activity for a few hours.

Exercising sport during the long-term ECG should therefore be exercised with caution. Pausing the sport for this day is an advantage, but not absolutely necessary.


The costs of a long-term EKG vary from practice to practice, but in most cases they amount to about 40 €. This includes the equipment with the electrodes and the recorder for one day, as well as the evaluation of all cardiac activities during the 24 hours by the doctor with possible diagnosis.

Some cardiology practices offer general heart examinations for around € 200, which include the long-term EKG and various other examinations. In most cases, the cost of a long-term EKG is covered by the health insurance company if there is a medical indication. Often a slight suspicion is enough, for example a palpitation of the heart, which prompts the cardiologist to conduct an examination.

Supraventricular extrasystoles (SVES)

SVES stands for "supraventricular extrasystoles". This is understood to be additional heartbeats that are triggered by the cardiac conduction system in the atrium (supraventricular = above the ventricle). You put one Cardiac arrhythmia which occurs every now and then in healthy people. Since they rarely appear continuously, they are almost exclusively can be determined by a long-term ECG.

In addition to the normal heartbeat, there are extra beats that look like normal heart excitation on the EKG, since they are formed in the atrium, like the normal heartbeat. If they occur in the context of other heart diseases, their cause should be determined and treated. In healthy people, they can also occur due to fatigue or after consumption of alcohol or nicotine.