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How is an Arrhythmia Diagnosed?

There are a number of diagnostic tests to determine if you have an arrhythmia, including the use of ECGs, monitors, and an Electrophysiology study.

ECG

An electrocardiogram (ECG or EKG) is a common and effective test for a general arrhythmia diagnosis. It records your heart's electrical currents, which the physician can then interpret to determine the type of arrhythmia you have. The ECG needs to be recorded while you are having the arrhythmia.

Holter monitor

A Holter monitor is a recording device that can be strapped to your chest, typically for a 24 hour period, to record your heart rate and rhythm. This increases the likelihood that the arrhythmia will occur and be recorded. By reading the device's printout, your physician can determine the nature of your arrhythmia.

Event monitor

The Event monitor is smaller than a Holter monitor. It may be no bigger than a beeper. Some monitors can be worn as wristwatches. When you feel the symptoms of an arrhythmia, you can phone a monitoring station, where a record can be made. If you don't have access to a phone during your symptoms, you can turn on the device's memory function. The recorded information can then be sent by phone to a monitoring station. You may have access to an event monitor for as long as a month at a time. Unless the arrhythmia is recorded, diagnosing an arrhythmia is very difficult.

Electrophysiology (EP) study

An electrophysiology study is the most specific way to record and diagnose an arrhythmia. An EP study is conducted in a cardiac catheterization lab or an electrophysiology lab, and is performed by an Electrophysiologist, a cardiac physician who is specialized in treating problems of the heart. Catheters (which are long, very thin tubes) are inserted in a vein in your leg, neck or arm, and guided up to your heart using X-ray. A record of electrical impulses from your heart is sent through the catheters, allowing the electrophysiologist to find out what kind of arrhythmia you have and where it starts. During the study, the physician may give you controlled electrical impulses to determine how your heart reacts (this doesn't hurt; you'll only feel your heart racing a little faster). Medication may be administered during the procedure to help start or stop the arrhythmia, and for patient comfort. If a fast abnormal heart rhythm is diagnosed, it is often treated during the same procedure with an ablation.

If a slow heart beat is diagnosed, your physician will discuss treatment options with you after the procedure.