Tests for arrhythmia

An arrhythmia is an abnormal heartbeat. Arrhythmia refers to a heartbeat that’s faster than average, slower than average, or irregular. Arrhythmias cause your heart to work harder than normal to maintain a constant supply of blood to the body. People who experience them may feel faint, dizzy, or lightheaded. Some arrhythmias may be harmless, but others can be serious or life threatening. In severe cases, an arrhythmia can cause cardiac arrest. There are several tests that physicians can use to diagnose arrhythmias.

This common test will give your doctor an overall idea of how your heart beats. This test is usually performed in the doctor’s office, where electrodes or patches are attached to different places on your chest, arms, and legs. The patches record your heart’s activity and draw a picture of how your heart beats. Your doctor will look at this pattern and determine if you have a heart problem. The test is short and painless.

Arrhythmias can happen at any time, making it difficult to chart irregular heartbeats with an ECG. In some cases, it’s necessary to monitor your heart over a long period. These three types of monitors can be used at home to record your heart:

Holter monitor

A Holter monitor records your heart’s activity over 24 to 48 hours. Like the ECG, you attach electrodes or patches to areas on your body and the monitor records your heart’s rhythm, which gives the doctor an overall picture of your heart’s activity.

Event monitors

People who have less frequent symptoms and can’t get to a doctor in time can use event monitors to record their symptoms. There are two main types of event monitor: symptom event monitors and looping memory monitors. Both are portable and designed to be carried around. Symptom event monitors are bracelets or handheld devices that feature small metal discs that function as electrodes. When you feel an irregular heartbeat or experience dizziness or fainting, you hold the device to your chest and push a button to record the event. The looping memory monitor is about the size of a pager. It connects to your body through electrodes that are attached to the monitor at all times. It can be configured to record your ECG for a preset amount of time once activated. The information is stored in the recorder for your doctor to analyze later.

Implantable loop recorders

This device records your heart’s activity like an event monitor, but it’s implanted under your skin. You or your doctor can program it to record an arrhythmia when it happens, or you can trigger the device to record with a remote.

There are several other tests your doctor may order to determine the type or cause of an arrhythmia:

Stress test

An exercise stress test is a common test used to see how your heart performs under stress or exercise and determine if the arrhythmia is related to exertion. Your doctor will attach electrodes to you as with an ECG, and ask you to run on a treadmill or pedal a stationary bicycle for a period of time while monitoring your heart.

A stress test can also be done with medication. The medicine will increase your heart rate instead of exercise, and you will be monitored with an ECG or Echocardiogram.

Tilt-table test

This test is used for people who faint often. During the test, your doctor will record your heart rate and blood pressure while you are lying flat on a table, and do so again several times as the position of the table changes. Your doctor may also give you medication through an IV to see how your heart responds in certain conditions. The test takes about 60 minutes.

Electrical physiological studies

This invasive procedure is useful for diagnosing certain types of arrhythmias in people who’ve had heart attacks or who have a fast heart rate, called tachycardia. Your doctor will thread thin wire electrodes through one of your veins and into your heart to study its rhythm.

Esophageal electrophysiologic procedure

In some cases, your doctor may perform an esophageal electrophysiological study, placing a soft, thin, plastic tube up your nostril and down into your esophagus. The esophagus is close to your heart’s upper chambers, and recording its rhythm there can be more precise than a regular ECG.

Transthoracic echocardiography (TTE) and echocardiograms

In these procedures, your doctor will take a picture of your heart using sonar waves to see its size, structure, and function. Your doctor will put gel on an instrument called a transducer and move it over your chest to image the areas of your heart.

In addition to monitoring your heart, your doctor may order blood tests to check your levels of calcium, potassium, and magnesium, which play a role in your heart’s electrical system. Your doctor may also want to check your cholesterol levels and the amount of carbon dioxide in your blood.

Your doctor will share all test results with you and may need to order more tests to make a complete diagnosis and develop a treatment plan for you. Be sure to discuss the results and treatment options with your doctor and ask any questions you have.

Most arrhythmias are harmless, but some can be serious, lead to other conditions, or even be fatal. It’s important to see your doctor immediately if you are experiencing symptoms of arrhythmia. The sooner you diagnose any potential issue, the sooner you can treat it, whether through medication, surgery, alternative treatments, or a combination of approaches. Early detection and treatment of an arrhythmia can help you go on to lead a healthy and fulfilling life.