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Tests and diagnosis

By Mayo Clinic staff

To diagnose a heart arrhythmia, your doctor may ask about — or test for — conditions that may trigger your arrhythmia, such as heart disease or a problem with your thyroid gland. Your doctor may also perform heart-monitoring tests specific to arrhythmias. These may include:

  • Electrocardiogram (ECG). During an ECG, sensors (electrodes) that can detect the electrical activity of your heart are attached to your chest and sometimes to your limbs. An ECG measures the timing and duration of each electrical phase in your heartbeat.
  • Holter monitor. This portable ECG device can be worn for a day or more to record your heart's activity as you go about your routine.
  • Event monitor. For sporadic arrhythmias, you keep this portable ECG device at home, attaching it to your body and pressing a button when you have symptoms. This lets your doctor check your heart rhythm at the time of your symptoms.
  • Echocardiogram. In this noninvasive test, a hand-held device (transducer) placed on your chest uses sound waves to produce images of your heart's size, structure and motion.

If your doctor doesn't find an arrhythmia during those tests, he or she may try to trigger your arrhythmia with other tests, which may include:

  • Stress test. Some arrhythmias are triggered or worsened by exercise. During a stress test, you'll be asked to exercise on a treadmill or stationary bicycle while your heart activity is monitored. If you have difficulty exercising, your doctor may use a drug to stimulate your heart in a way that's similar to exercise.
  • Tilt table test. Your doctor may recommend this test if you've had fainting spells. Your heart rate and blood pressure are monitored as you lie flat on a table. The table is then tilted as if you were standing up. Your doctor observes how your heart and the nervous system that controls it respond to the change in angle.
  • Electrophysiological testing and mapping. In this test, thin, flexible tubes (catheters) tipped with electrodes are threaded through your blood vessels to a variety of spots within your heart. Once in place, the electrodes can map the spread of electrical impulses through your heart. In addition, your cardiologist can use the electrodes to stimulate your heart to beat at rates that may trigger — or halt — an arrhythmia. This allows your doctor to see the location of the arrhythmia and what may be causing it.
Treatments and drugs Preparing for your appointment
References
  1. Arrhythmias. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/cardiovascular_disorders/arrhythmias_and_conduction_disorders/overview_of_arrhythmias.html. Accessed Jan. 29. 2013.
  2. What is an arrhythmia? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/arr/. Accessed Jan. 29, 2013.
  3. Substances & heart rhythm disorders. Heart Rhythm Society. http://www.hrsonline.org/Patient-Resources/Substances-Heart-Rhythm-Disorders#axzz2JbtJY5qH. Accessed Jan. 31, 2013.
  4. Stone CK, et al. Current Diagnosis & Treatment Emergency Medicine. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=55753892. Accessed January 28, 2013.
  5. Wang, PJ, et al. Supraventricular tachycardia. Circulation. 2002;106:e206.
  6. Drugs with risk of Torsades de Pointes. Credible Meds. http://www.azcert.org/medical-pros/drug-lists/list-01.cfm?sort=Generic_name. Accessed Jan. 30, 2013.
  7. Drugs with possible risk of Torsades de Pointes. http://www.azcert.org/medical-pros/drug-lists/list-02.cfm. Accessed Jan. 30, 2013.
  8. Understand your risk for arrhythmia. American Heart Association. http://www.heart.org/HEARTORG/Conditions/Arrhythmia/UnderstandYourRiskforArrhythmia/Understand-Your-Risk-for-Arrhythmia_UCM_002024_Article.jsp. Accessed Jan. 30, 2013.
  9. Antithrombotic therapy supplement. Bloomington, Minn.: Institute for Clinical Systems Improvement.https://www.icsi.org/_asset/bjr47w/Antithromb-Interactive0512.pdf. Accessed Jan. 29, 2013.
  10. Pradaxa (dabigatran etexilate mesylate): Drug safety communication. U.S. Food and Drug Administration. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm282820.htm. Accessed Jan.28, 2013.
  11. Rix TA, et al. Omega-3 fatty acids and cardiac arrhythmias. Current Opinion in Clinical Nutrition and Metabolic Care. In press. Accessed Jan. 29, 2013.
  12. U.S. News best hospitals: Cardiology & heart surgery. U.S. News and World Report. http://health.usnews.com/best-hospitals/rankings/cardiology-and-heart-surgery. Accessed Feb. 1, 2013.
  13. Hands-only CPR fact sheet. American Heart Association. http://www.heart.org/HEARTORG/CPRAndECC/HandsOnlyCPR/LearnMore/Learn-More_UCM_440810_FAQ.jsp. Accessed Feb. 10, 2013.
DS00290 Feb. 27, 2013

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