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Diagnosis of Arrhythmias (Heart Rhythm Disturbances)
- Holter monitor—A small machine is belted around your waist and will record your heart rhythm over a period of 24 hours or more.
- Transtelephonic monitoring—Instead of a Holter monitor, you may take home a device that allows you to send your EKG recording over the telephone at the moment you feel symptoms of an arrhythmia.
- Implantable loop recorder—If a longer period of recording is necessary, a small rectangular recording device may be surgically implanted underneath the skin of the chest. If the EKG-like information recorded falls within certain normal limits, the device erases the data. Abnormal heart rhythms are retained until your doctor retrieves the information.
Tests to Look for Causes
- Cardiac catheterization and coronary angiography —To help detect obstruction in the arteries of heart and assess heart function.
- Chest x-ray —To look for heart enlargement or congestion in the lungs.
- Nuclear Scanning—To visualize the blood supply to the heart. Areas with poor blood supply can potentially generate abnormal rhythms.
- CT and MRI Angiography —To highlight blood vessels and see where blockage occurs.
- Echocardiogram —Ultrasound is used to evaluate the size, shape, and motion of the heart. A more specialized version uses the Doppler effect to visualize blood flow.
- Blood and urine tests—To evaluate your overall health, and fluid and electrolyte levels. These tests can also detect problems with your kidneys or liver.
- Tilt table testing —This test is usually ordered for people with fainting episodes. Your heart rate and blood pressure are closely monitored while you are first lying flat on a table and then when the table is tilted. It may help determine the cause of your fainting.
- Electrophysiologic testing —This is an invasive test that is generally reserved for complex rhythm disturbances or to assess treatment. The test is done by passing an electrode through the blood vessels to the heart. The electrode can provide information on electrical activity of the heart and the spread of electrical impulses through the heart. It may also be used during invasive procedures to guide treatment to help manage heart problems.
Abbott A. Diagnostic approach to palpitations. Am Fam Physcian. 2005;7(4):743-750. Available at: http://www.aafp.org/afp/2005/0215/p743.html. Accessed March 20, 2014.
Bruce GK, Friedman PA. Device-based therapies for atrial fibrillation. Curr Treat Options Cardiovasc Med. 2005;7(5):359-370.
Common tests for arrhythmia. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/Arrhythmia/SymptomsDiagnosisMonitoringofArrhythmia/Common-Tests-for-Arrhythmia%5FUCM%5F301988%5FArticle.jsp. Updated December 7, 2012. Accessed March 20, 2014.
Crawford MH, Bernstein SJ, Deedwania PC, et al, for the American College of Cardiology/American Heart Association task force on practice guidelines. ACC/AHA guidelines for ambulatory electrocardiography: Executive summary and recommendations. Circulation. 1999;100:886.
Diagnosis & symptoms. Heart Rhythm Society website. Available at: http://www.hrsonline.org/Patient-Resources/Symptoms-Diagnosis#axzz2wVpruTrZ. Accessed March 20, 2014.
How arrhythmias are diagnosed. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/arr/diagnosis.html. Updated July 1, 2011. Accessed March 20, 2014.
Krahn AD, Klein GJ, Skanes AC, Yee R. Insertable loop recorder use for detection of intermittent arrhythmias (review). Pacing Clin Electrophysiol. 2004;27(5):657-664.
- Reviewer: Michael J. Fucci, DO
- Review Date: 12/2013
- Update Date: 00/32/2014