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Diagnosing Heart Arrhythmias

Your physician may suspect a heart arrhythmia, if you have experienced a premature beat that feels like a skipped heart beat or a series of premature beats that gives a fluttering sensation in your chest area.

Additional symptoms can also include, fatigue, dizziness, light headedness, fainting (syncope) or near-fainting spell, rapid heartbeat or pounding, shortness of breath, and chest pain. Your physician may order a number of the following tests to diagnose your heart arrhythmia.

Image of the test results for an abnormal heartbeat

How are arrhythmias diagnosed?

There are several tests that may be used to diagnose arrhythmias. Some of these include:

An electrocardiogram is a measurement of the electrical activity of your heart. By placing electrodes at specific locations on your body (chest, arms, and legs), a graphic representation, or tracing, of the electrical activity can be made as the electrical activity received and interpreted by an ECG machine. An ECG can show the presence of arrhythmias, damage to your heart caused by ischemia (lack of oxygen to the heart muscle), or myocardial infarction (MI, or heart attack), a problem with one or more of the heart valves, or other types of heart conditions.

Small sticky patches called electrodes are attached to your chest, arms, and legs. These electrodes are connected to the ECG machine by wires. The ECG machine is then started and records your heart's electrical activity for a minute or so. You are lying down during this ECG.

You are attached to the ECG machine as described above. However, rather than laying down, you exercise by walking on a treadmill or pedaling a stationary bike while the ECG is recorded. This test is done to assess changes in the ECG during stress, such as exercise.

This procedure is done in the same manner as a resting ECG, except your heart's electrical activity is recorded over a longer period of time, usually 15 to 20 minutes. Signal-averaged ECGs are done when arrhythmia is suspected, but not seen on a resting ECG. The signal-averaged ECG has increased sensitivity to abnormal ventricular activity called "late potentials." Signal-averaged ECG is used in research and seldom used in clinical practice.

A nonsurgical but invasive test in which a small, thin tube (catheter) is inserted into a large blood vessel in your leg or arm and advanced to your heart. This lets your doctor find the site of the arrhythmia's origin within your heart tissue.

A small, portable ECG recorder, that can record 24 hours of continuous electrocardiographic signals.

This is similar to a Holter monitor, except that you start the ECG recording only when you feel symptoms. Event monitors are typically worn longer than Holter monitors. You can remove the monitor to shower or bathe.

This is a miniature heart recording device that is implanted underneath the skin overlying your heart. It can record the heart rhythm for up to 2 years and is useful in diagnosing intermediate or rarely occurring arrhythmias.