Tests for Detecting Arrhythmias
Electrocardiogram (ECG or EKG). A record of the electrical activity of the heart. Disks are placed on the chest and connected by wires to a recording machine. The heart's electrical signals cause a pen to draw lines across a strip of graph paper in the ECG machine. The doctor studies the shapes of these lines to check for any changes in the normal rhythm. The types of ECGs are:
Resting ECG. The patient lies down for a few minutes while a record is made. In this type of ECG, disks are attached to the patient's arms and legs as well as to the chest.
Exercise ECG (stress test). The patient exercises either on a treadmill machine or bicycle while connected to the ECG machine. This test tells whether exercise causes arrhythmias or makes them worse or whether there is evidence of inadequate blood flow to the heart muscle ("ischemia").
24-hour ECG (Holter) monitoring. The patient goes about his or her usual daily activities while wearing a small, portable tape recorder that connects to the disks on the patient's chest. Over time, this test shows changes in rhythm (or "ischemia") that may not be detected during a resting or exercise ECG.
Transtelephonic monitoring. The patient wears the tape recorder and disks over a period of a few days to several weeks. When the patient feels an arrhythmia, he or she telephones a monitoring station where the record is made. If access to a telephone is not possible, the patient has the option of activating the monitor's memory function. Later, when a telephone is accessible, the patient can transmit the recorded information from the memory to the monitoring station. Transtelephonic monitoring can reveal arrhythmias that occur only once every few days or weeks.
Electrophysiologic study (EPS). A test for arrhythmias that involves cardiac catheterization. Very thin, flexible tubes (catheters) are placed in a vein of an arm or (eg and advanced to the right atrium and ventricle. This procedure allows doctors to find the site and type of arrhythmia and how it responds to treatment.
How are arrhythmias treated?
Many arrhythmias require no treatment whatsoever. Serious arrhythmias are treated in several ways depending on what is causing the arrhythmia. Sometimes the heart disease is treated to control the arrhythmia. Or, the arrhythmia itself may be treated using one or more of the following treatments.