Diagnosing arrhythmias involves several steps that help to determine the type and cause of the abnormal heart rhythms. Since arrhythmias can be intermittent and not always present during a doctor’s visit, multiple diagnostic tools and methods are employed to capture and analyze the heart’s activity. Here’s how arrhythmias are typically diagnosed:
1. Medical History and Physical Examination
- Medical and Family History: A doctor will gather information about any symptoms experienced, medical conditions, family history of heart disease, and any potential triggers for the arrhythmia.
- Physical Exam: Listening to the heart rate and rhythm with a stethoscope, checking pulse, and looking for signs of fluid retention.
2. Electrocardiogram (ECG or EKG)
- Standard ECG: Records the electrical signals of the heart and can detect arrhythmias, heart damage, and electrolyte imbalances. It’s the primary tool for diagnosing arrhythmias.
- Holter Monitor: A portable ECG device worn for a day or more to record the heart’s activity over an extended period, capturing arrhythmias that might not occur during a standard ECG.
- Event Monitor: Similar to a Holter monitor, but used for longer periods (a few weeks to months), and the patient activates it when symptoms occur.
- Sometimes called a treadmill test or exercise test, it monitors the heart’s activity during physical exertion, revealing arrhythmias that are triggered or worsened by exercise.
- An ultrasound of the heart that creates detailed images of the heart’s structure and function. It can help identify underlying causes of arrhythmias, such as heart disease or problems with the heart valves.
5. Electrophysiological Testing (EP Study)
- An invasive test where catheters are threaded into the heart through a vein in the groin. Electrodes at the catheter tips can precisely map the heart’s electrical signals and stimulate the heart to trigger an arrhythmia under controlled conditions, helping to pinpoint its location and best treatment options.
- A small device implanted under the skin of the chest to continuously record the heart’s electrical activity for up to three years, used for diagnosing intermittent arrhythmias that are infrequent and not captured by other means.
- To check for underlying conditions that might lead to an arrhythmia, such as thyroid disease or an imbalance in electrolytes like potassium or magnesium.
- Used to view the size and shape of the heart and its surrounding organs. It can help identify conditions that may cause or contribute to arrhythmias.
By utilizing these diagnostic methods, healthcare providers can determine the type of arrhythmia, assess its severity, understand its causes, and develop an effective treatment plan.