How is cardiac arrhythmia diagnosed?
Cardiac arrhythmias are often first detected by simple but nonspecific means: auscultation of the heartbeat with a stethoscope, or feeling for peripheral pulses. These cannot diagnose specific arrhythmias, but can give a general indication of the heart rate and whether it is regular or irregular. Not all the electrical impulses of the heart produce audible or palpable
beats; in many cardiac arrhythmias, the premature or abnormal beats do not produce an effective pumping action and are experienced as "skipped" beats.
The simplest specific diagnostic test for assessment of heart rhythm is the electrocardiogram (abbreviated ECG or EKG). A Holter monitor is an ECG recorded over a 24-hour period, to detect arrhythmias that may happen briefly and unpredictably throughout the day. However, because cardiac arrhythmias may come and go, a one-time office EKG may be normal. If this is the case, an ambulatory EKG may be required. During an ambulatory EKG, the patient wears a portable EKG machine called a Holter monitor, usually for 24 hours. Alternatively, you may wear a device for much longer. You will be taught to press a button to record the EKG reading whenever you experience symptoms. This approach is especially useful if you experience infrequent symptoms of arrhythmia.
In rare cases, invasive electrophysiological studies are necessary to determine the exact location responsible for an arrhythmia. These involve introducing electrical sensors into the body, close to or within the heart, rather than sensing electrical waves from the surface of the body as an ECG does. An electrophysiology (EP) study provides the physician with more accurate and detailed information about the hearts electrical function than the other studies. Based on the information gathered during the EP study, your physician can diagnose your particular arrhythmia problem and select the appropriate treatment.
This test is performed in a specially equipped room, usually referred to as the EP Lab. During the study, doctors place special electrode catheters (long, flexible wires) into the veins and guide them into the heart. These catheters are used to measure the electrical conduction system of the heart. They are also used to stimulate different regions of the heart (known as pacing) to attempt to induce an arrhythmia. The procedure is very safe and effective in diagnosing cardiac arrhythmias. A team of highly trained physicians and nurses care for you during the procedure.
After being positioned on an X-ray table, you will be connected to a variety of monitors that measure heart rate, blood pressure and oxygen level. A medication is given through an IV to relax you and to make you feel sleepy (this is called conscious sedation). A local anesthetic is used to numb the area where the physician will place the catheters. After the area is numb (the groin, arm or neck), catheters will be inserted into the vein(s) and positioned in the heart using X-ray imaging. Once the catheters are positioned, you may feel a sensation in the chest as the physicians are pacing your heart. This is often felt as a fluttering sensation.Most patients sleep through the procedure and tolerate it nicely. After the EP study, which generally takes 1-2 hours, the catheters are removed and pressure is held at the site where the catheters entered the body. From the EP lab, you are brought back to your room and asked to remain on bed rest for 4-6 hours while the vein(s) heals. Your cardiologist will discuss the results of the study with you and recommend an appropriate course of action.
More information on cardiac arrhythmia
What is cardiac arrhythmia? - Cardiac arrhythmia is a disturbance of the heart rhythm. Cardiac arrhythmias can range in severity from entirely benign to immediately life-threatening.
What types of cardiac arrhythmias are there? - Types of cardiac arrhythmias include supraventricular tachycardia, Wolff-Parkinson-White syndrome, atrial fibrillation, ventricular fibrillation, bradycardia.
What causes cardiac arrhythmias? - Cardiac Arrhythmias occur when the heart beats improperly, as a result of incorrect impulse generation, or impulse conduction.
What're the symptoms of cardiac arrhythmia? - The signs and symptoms of cardiac arrhythmias can range from completely asymptomatic to loss of consciousness or sudden cardiac death.
How is cardiac arrhythmia diagnosed? - Cardiac arrhythmias are often first detected by simple but nonspecific means. One diagnostic test for assessment of heart rhythm is the electrocardiogram.
What're the treatments for cardiac arrhythmia? - The pharmacological treatments for cardiac arrhythmia consist of agents that interfere with sodium, pottasium, and calcium pump systems.