Heart Arrhythmia

To diagnose a heart arrhythmia, a healthcare professional examines you and asks about your medical history and symptoms.

You may have tests to check your heart and to look for health conditions that can cause an irregular heartbeat.

Tests

Tests to diagnose a heart arrhythmia may include:

• Electrocardiogram (ECG or EKG). This quick test measures the electrical activity of the heart. It can show how fast or how slow the heart is beating. Sticky patches called sensors are attached to the chest and sometimes to the arms or legs. Wires connect the patches to a computer, which displays or prints results.
• Holter monitor. This portable ECG device can be worn for a day or more to record the heart’s activity during daily activities.
• Event recorder. This portable ECG device is worn for up to 30 days or until an arrhythmia or symptoms occur. You typically press a button when symptoms occur.
• Echocardiogram. This test uses sound waves to take pictures of the beating heart. It can show the structure of the heart and heart valves. It can measure the strength of the heart. It also shows how blood flows through the heart.
• Implantable loop recorder. If symptoms are very infrequent, an event recorder may be implanted under the skin in the chest area. The device continuously records the heart’s electrical activity. It can find irregular heart rhythms.

If an irregular heartbeat is not found during those tests, a healthcare professional may suggest more tests to try to trigger the arrhythmia. These tests may include:

• Stress test. Some arrhythmias are triggered or worsened by exercise. During a stress test, the heart’s activity is watched while you ride on a stationary bicycle or walk on a treadmill. If you can’t exercise, you may be given medicine that affects the heart in a way that’s similar to exercise.
• Tilt table test. This test may be done if you’ve had fainting spells. Your heart rate and blood pressure are checked as you lie flat on a table. The table is then tilted to put you in a standing position. A healthcare professional watches how your heart and nervous system respond to the change in angle.
• Electrophysiological (EP) testing and mapping. This test, also called an EP study, can confirm a diagnosis of tachycardia or find out where in the heart the faulty signaling occurs. An EP study is mostly used to diagnose isolated arrythmias.An EP study is done in the hospital. One or more thin, flexible tubes are guided through a blood vessel, usually in the groin, to various areas in the heart. Sensors on the tips of the tubes record the heart’s electrical activity. An EP study shows how electrical signals spread through the heart during each heartbeat.