Arrhythmia Diagnosis

I receive lots of questions about a variety of heart conditions. And one of the most common I receive is about arrhythmias. Specifically, I am often asked how to determine if, in fact, you have an arrhythmia.

One of the first things you need to do is see a cardiologist so they can determine a baseline electrocardiogram (EKG) and do a Holter monitor evaluation. These are very basic, noninvasive tests that your insurance will pay for. Your arrhythmia may show up on the EKG, but your doctor will still want to assess how often it’s happening with the Holter monitor.

For the Holter, you will have a few (4) adhesive electrode pads placed on your chest.  Wires attached to those electrodes will be connected to a recorder box that you can wear on your belt (or in a sling if you prefer). You will be asked to keep a diary of your activity and your symptoms for the next 24 hours, including any awareness you have of skipped or fast heartbeats. You should also track and document your blood pressure levels.

The recording is then analyzed by advanced computers that show pictures of your heart’s rhythm so that your doctor can see what kind of arrhythmia you have. Fast heartbeats for long time periods can occur with what we medically refer to as atrial fibrillation (AF) and supraventricular tachycardias (SVTs: supraventricular identifies the source of the problem in the conduction system; tachy=fast, cardia = heart).

In the event that there is no arrhythmia during your EKG and you fail to experience any symptoms during the 24 hours of monitoring, you can use an event monitor for a month—a Holter-type device you connect to when your symptoms arise.

Once your doctor identifies the type of arrhythmia you have, he or she can look for underlying causes that need to be addressed, including enlargement of the upper chambers of the heart, aging, valve issues, and more. Should you have frequent episodes of AF, you may need to prevent blood clots that can form if your upper chambers are not pumping effectively during times of arrhythmia. 

For more information on cardiovascular problems, visit www.drsinatra.com.