Common Tests for Arrhythmia

Updated:Dec 21,2016

Several tests can help your doctor diagnose an arrhythmia. View an animation of arrhythmia.

Common Tests for Arrhythmia

Holter monitor (continuous ambulatory electrocardiographic monitor)

Suspected arrhythmias sometimes may be documented by using a small, portable ECG recorder, called a Holter monitor (or continuous ambulatory electrocardiographic monitor). This can record 24 hours (and sometimes more) of continuous electrocardiographic signals. While an ECG is sort of a 12-second "snapshot" of the heart's electrical activity, the Holter monitor is more like a "movie."

As with an ECG, electrodes are taped to the chest. The wires are connected to a portable, battery-operated recorder that can run for 24 to 48 hours. You can do most normal activities while being tested. You may need to keep a diary or log of your activities and symptoms.

At the end of the measurement period, the recorder’s tape or memory is analyzed on a computer that rapidly identifies rhythm disturbances that occurred while you were wearing the monitor. The diary helps your healthcare professional see how your activities or symptoms correspond to recorded events in your heart.

For suspected arrhythmias that occur less frequently than every day, your doctor might have you wear an event monitor.

Download our printable Holter monitor diary form.

Learn more about Holter Monitors.

Suspected arrhythmias sometimes may be documented by using a small, portable ECG recorder, called a Holter monitor (or continuous ambulatory electrocardiographic monitor). This can record 24 hours (and sometimes more) of continuous electrocardiographic signals. While an ECG is sort of a 12-second "snapshot" of the heart's electrical activity, the Holter monitor is more like a "movie."

As with an ECG, electrodes are taped to the chest. The wires are connected to a portable, battery-operated recorder that can run for 24 to 48 hours. You can do most normal activities while being tested. You may need to keep a diary or log of your activities and symptoms.

At the end of the measurement period, the recorder’s tape or memory is analyzed on a computer that rapidly identifies rhythm disturbances that occurred while you were wearing the monitor. The diary helps your healthcare professional see how your activities or symptoms correspond to recorded events in your heart.

For suspected arrhythmias that occur less frequently than every day, your doctor might have you wear an event monitor.

Download our printable Holter monitor diary form.

Learn more about Holter Monitors.

Sometimes arrhythmia symptoms happen infrequently or pass so quickly that you can't get to a doctor or hospital. In these cases, a transient event monitor may be used. This small recorder is sent home with you for a month or two. When you have symptoms, attach the recorder with bracelets, finger clips or patches under the arms. The ECG will be recorded and stored. When it's convenient, you can transmit the ECG by phone to your cardiologist to be analyzed.

Learn more about Cardiac Event Recorders.

This is an option that provokes arrhythmias and makes their diagnosis (and thus their proper treatment) easier. A treadmill test may be used for people whose suspected arrhythmias are clearly exercise-related. It is important to know if exercise makes an arrhythmia worse. To test this, you will walk and run on a treadmill — or ride a stationary bicycle — while your heart rate and rhythm are monitored.

Learn more about the exercise stress test.

A tilt test may be advised for some people who've had recurrent fainting spells (syncope). This test shows how your heart rate and blood pressure respond to a change in position from lying down to standing up. In this test, an intravenous line (a small plastic tube in a vein) is usually started in case medications need to be given during the test. A catheter also may be placed in the artery to monitor blood pressure from inside the artery. If a cause of the fainting spells is found, medications can be given through the intravenous line to help prevent the episodes.

Learn more about Tilt-Table Tests.

This method has become extremely valuable for provoking known but infrequent arrhythmias and for unmasking suspected arrhythmias. This procedure is done using local anesthesia. Temporary electrode catheters are placed through peripheral veins (or arteries) into the heart using a fluoroscope. Then these catheters are positioned in the atria, ventricles or both, and at strategic locations along the conduction system. They record cardiac electrical signals and "map" the spread of electrical impulses during each beat, thus showing where the heart block is (AV node vs. His-Purkinje system). This test also shows where tachycardia originates (supraventricular vs. ventricular) far better than an ECG usually does.

The ability to electrically stimulate the heart at programmed rates and induce precisely timed premature beats lets a doctor assess electrical properties of the heart's conduction system. Most significantly, it also triggers latent tachycardia or bradycardia. Induced tachycardias can usually be stopped by rapid pacing via the electrode catheters. Sometimes an externally applied shock may be required if the patient loses consciousness during the tachycardia. Being able to "turn on" and "turn off" tachycardias during electrophysiologic studies allows antiarrhythmic drugs to be tested quickly for effectiveness. This can be done during a single study using intravenous therapy or during short follow-up studies with oral medication.

In some situations, your cardiologist may advise doing an esophageal electrophysiologic procedure. This is used to diagnose or treat the type of tachycardia you have. A thin, soft, flexible plastic tube will be inserted into your nostril and positioned in the esophagus (the tube that connects the mouth and stomach). Because the esophagus is close to the heart's upper chambers (atria), an ECG recording there gives more precise information than a regular ECG. An electrical stimulator may be used to make the heart beat faster to try to restart your arrhythmia. This helps your doctor make the right diagnosis.

During this procedure certain medications may be tested to find the most effective one. This procedure also may be done to temporarily stop certain types of arrhythmias.

Echocardiography works much like sound waves used to study solid objects in the sea (sonar). You may only think of ultrasound being used to monitor a baby's growth, but ultrasound waves can also show the heart's size, structure and motion. This simple, painless test often provides valuable information about a heart with an arrhythmia. Transthoracic echocardiography (TTE) is the most common type of Echocardiogram.

Learn more about Echocardiography.





This content was last reviewed September 2016.
 


 Arrhythmia

Subscribe to Heart Insight magazine and monthly e-newsletter
Heart Insight logo
Our digital magazine delivers helpful articles and the latest news on keeping your heart healthy. Sign up today!
 

 

 

 
 
By clicking submit below you agree to the Terms and Conditions and Privacy Policy