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How you prepare

By Mayo Clinic staff

Heart-Healthy Living

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Before your doctor decides if you need a pacemaker, you'll have several tests done to find out the cause of your irregular heartbeat. These could include:

  • Electrocardiogram. In this noninvasive test, sensor pads with wires attached, called electrodes, are placed on your chest and sometimes limbs to measure your heart's electrical impulses. Your heart's beating pattern can offer clues to the type of irregular heartbeat you have.
  • Holter monitoring. Also known as an ambulatory electrocardiogram monitor, a Holter monitor records your heart rhythms for an entire 24-hour period. Wires from electrodes on your chest go to a battery-operated recording device carried in your pocket or worn on a belt or shoulder strap. While you're wearing the monitor, you'll keep a diary of your activities and symptoms. Your doctor will compare the diary with the electrical recordings to try to figure out the cause of your symptoms.
  • Echocardiogram. This noninvasive test uses harmless sound waves that allow your doctor to see your heart without making an incision. During the procedure, a small, plastic instrument called a transducer is placed on your chest. It collects reflected sound waves (echoes) from your heart and transmits them to a machine that uses the sound wave patterns to compose images of your beating heart on a monitor. These images show how well your heart is functioning, and recorded pictures allow your doctor to measure the size and thickness of your heart muscle.
  • Stress test. Some heart problems occur only during exercise. For a stress test, an echocardiogram or electrocardiogram is taken before and immediately after walking on a treadmill or riding a stationary bike. Other types of treadmill exercise tests also can be done to evaluate your heart, including an oxygen consumption test that measures how much oxygen your body is using.
What you can expect Risks
References
  1. Tracy CM, et al. 2012 ACCF/AHA/HRS focused update of the 2008 guidelines for device-based therapy of cardiac rhythm abnormalities — A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. The Journal of Thoracic and Cardiovascular Surgery. 2012;144:e27.
  2. What is a pacemaker? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/pace/. Accessed Jan. 29, 2013.
  3. What is a pacemaker? American Heart Association. http://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300451.pdf. Accessed Jan. 29, 2013.
  4. How the healthy heart works. American Heart Association. http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/How-the-Healthy-Heart-Works_UCM_307016_Article.jsp. Accessed Jan. 26, 2013.
  5. Fuster V, ed., et al. Hurst's The Heart. 13th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=5. Accessed Jan. 28, 2013.
  6. Goldberger AL, et al. Clinical Electrocardiography: A simplified approach. 8th ed. Philadelphia, Pa.: Elsevier Saunders; 2013. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-08786-5..C2010-0-67269-5&isbn=978-0-323-08786-5&uniqId=402077730-3#4-u1.0-B978-0-323-08786-5..C2010-0-67269-5--TOP. Accessed Jan. 29, 2013.
  7. Saxon LA, et al. Overview of cardiac pacing in heart failure. http://www.uptodate.com/home. Accessed Jan. 29, 2013.
  8. McKean SC, et al. Principles and Practice of Hospital Medicine. New York, N.Y: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=749. Accessed Jan. 25, 2013.
  9. Lampert R, et al. HRS Expert Consensus Statement on the Management of Cardiovascular Implantable Electronic Devices (CIEDs) in patients nearing end of life or requesting withdrawal of therapy. 2010;7:1008.
  10. Grogan M (expert opinion). Mayo Clinic, Rochester, Minn. March 17, 2013.
MY00276 April 17, 2013

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