Arrhythmia

Diagnosis

To diagnose a heart arrhythmia, a healthcare professional will examine you, ask about your symptoms, and review your medical history. Tests may be done to evaluate your heart and identify conditions that could cause an irregular heartbeat.

Tests
Tests used to diagnose heart arrhythmias may include:

• Electrocardiogram (ECG or EKG). This quick test records the electrical activity of the heart. Sticky patches called sensors are placed on the chest, arms, or legs, connected to a computer that displays or prints results.

• Holter monitor. This portable ECG device is worn for 24 hours or longer to record heart activity during daily routines.

• Event recorder. A device worn up to 30 days to record heart activity when symptoms occur; usually activated by pressing a button.

• Echocardiogram. Uses sound waves to create images of the heart, showing its structure, valve function, and blood flow.

• Implantable loop recorder. For infrequent symptoms, this small device is implanted under the skin to continuously monitor the heart’s electrical activity.

If arrhythmias are not detected, additional tests may include:

• Stress test. Monitors heart activity during exercise or when given medications that mimic exercise effects.

• Tilt table test. Measures heart rate and blood pressure as you move from lying to standing, useful for fainting episodes.

• Electrophysiological (EP) study. Thin tubes with sensors are guided through a blood vessel to the heart to map electrical activity and pinpoint abnormal signals.

An EP study is usually done in a hospital. Sensors on catheter tips record how electrical signals spread through the heart during each heartbeat.

Treatment

Treatment depends on whether the heart is beating too fast, too slow, or irregularly. Some arrhythmias may require no treatment, while others need medicines, therapies, or procedures.

Medicines
Medications are used to control heart rate, restore normal rhythm, or prevent complications such as blood clots. For example, people with tachycardia may receive heart rate or rhythm medications, while atrial fibrillation may require blood thinners.

Therapies

• Vagal maneuvers. Specific actions, such as coughing, bearing down, or applying an ice pack to the face, may slow certain fast heartbeats.

• Cardioversion. Electrical shocks through paddles or patches may restore normal rhythm when other methods fail.

Procedures and surgeries

• Catheter ablation. Catheters create small scars to block faulty electrical signals.

• Pacemaker. Implanted in the chest to regulate slow heartbeats.

• Implantable cardioverter-defibrillator (ICD). Monitors rhythm and delivers shocks to correct dangerous arrhythmias.

• Maze procedure. Small incisions create scar tissue that blocks abnormal signals, often performed during open-heart surgery.

• Coronary bypass graft surgery. Creates new pathways for blood flow if blocked arteries contribute to arrhythmias.

After treatment, regular checkups are important. Follow your prescribed medicines and report any worsening symptoms to your healthcare provider.