Before discussing how to diagnose heart arrhythmia, it’s important to define the term. Arrhythmia (or dysrhythmia) is a term used to describe abnormal or irregular heartbeats, and are characterized by heartbeats that are too slow, too fast, or irregular.
Types of Arrhythmias
There are two types of arrhythmias in regards to the rate of a heartbeat. A fast heartbeat (heart rate above 100 heartbeats per minute) is known as Tachycardia. A slow heartbeat (heart rate less than 60 beats per minute) is known as Bradycardia. Arrhythmias can also be classified according to whether they originate in the upper chambers of the heart (atria), or lower chambers of the heart (ventricles).
While some arrhythmias can occur without obvious symptoms, the common symptoms include shortness of breath, a sensation of pounding chest, palpitations (skipping heartbeats), dizziness, chest discomfort, fainting/near-fainting, and weakness or fatigue.
Heart arrhythmias can affect anyone, but some are more common with age. Additionally, some other factors place some people at a greater risk than others.
How to Diagnose Heart Arrhythmia
Doctors detect irregular heartbeats during an examination that may involve checking a patient’s pulse, listening to their heart, and/or performing diagnostic tests. There are several tests done to confirm arrhythmia. The diagnosis process begins with a review of symptoms, medical history, and a physical exam.
Your doctor will begin by reviewing any symptoms you have before they review your medical history and perform a physical examination. Medical history review includes establishing past heart conditions/problems like a heart attack. Your doctor may also ask questions to establish if you have any conditions that may have triggered your arrhythmia such as underlying heart disease or thyroid problems. He/she may also test for such conditions.
II. Heart-monitoring Tests
The review process should be followed by heart-monitoring tests specifically meant to test for arrhythmias. The tests include:
a. Electrocardiogram or ECG
This test lets your doctor know how your heart beats. An ECG test is performed at a doctor’s office. It involves attaching electrodes (or patches) to different areas of a patient’s chest, legs, and arms. The patches record heart activity, drawing a pattern of how a patient’s heart beats. Based on the pattern (which records heartbeat timing and duration), a doctor can establish whether a patient has a heart problem or not. An ECG test is quick and painless.
b. Blood Testing
Doctors can also order blood tests to diagnose heart arrhythmia. The tests reveal the levels of potassium, calcium, and magnesium in a patient’s body, which play a critical role in the heart’s electrical system. Other related tests that may be administered include cholesterol and blood carbon dioxide level tests.
An echocardiogram is a non-invasive test used to check the structure and function of the heart, the heart valves, and also the size of the cardiac chambers that will help to diagnose heart arrhythmia. The test is done using a handheld transducer placed on the outside of the chest. The transducer uses sound waves to take pictures that give vital information about a patient’s heart size, motion, and structure.
d. Stress Test
In some cases, arrhythmia can be triggered/worsened by stress. A typical stress test involves subjecting the body to some stress i.e., exercise. During a stress test, a patient may be asked to walk, jog, or run on a treadmill while their heart activity is closely monitored. In cases where the arrhythmia is linked to coronary artery disease, and a patient has difficulty breathing, the doctor can stimulate the heart in other ways (using a drug).
III. Testing Using Event Monitors & Devices
Heart arrhythmias can also be diagnosed through special monitors and devices. Tests may fail to detect heartbeat irregularities. Arrhythmias can take place at any time creating the need to monitor heartbeats over a longer time using event monitors and devices. The main event monitors and devices used to diagnose heart arrhythmias include;
a. Holter Monitor
A Holter monitor is simply a portable ECG device wearable for usually 1-2 days to continuously monitor and record a patient’s heart activity while the patient engages in day-to-day activities. This device is used to diagnose arrhythmias when typical ECG tests conducted at a doctor’s office are inconclusive. A Holter monitor is also handy when dealing with infrequent heartbeats that may occur daily, making it hard to “catch” them at the doctor’s office.
b. Event Monitor
An event monitor is a small portable recorder worn continuously for a longer period of time to monitor and record heart rhythm information when a person experiences arrhythmia symptoms such as heart pounding, dizziness, etc. When a patient experiences a symptom, a recording is initiated by pushing an event button, after which the heart rhythm is recorded and transmitted for review.
c. Implantable Loop Recorder
Heart arrhythmia diagnosis can also be done using an implantable loop recorder. If a patient’s symptoms are very infrequent such as once or twice a month, a device can be implanted under a patient’s skin (in the chest region) to continuously record heart activity detecting and recording abnormal heart rhythms.
As the name suggests, implantable loop recorders are implanted into the body (under the skin) during a simple outpatient procedure. A doctor can program the recorder to monitor and record heartbeat irregularities when they happen. The device recordings are also transmitted to a site for review by the physician in order to aid in the detection of infrequent arrhythmias.
IV. Other Tests for Diagnosing Heart Arrhythmia
If the doctor doesn’t diagnose arrhythmia using the above tests, he/she may consider other tests such as;
a. Tilt Table Test
This test is normally used to diagnose heart arrhythmia among patients who have had fainting spells. A patient’s heart rate and blood pressure are monitored as they lie flat on an adjustable bed/table, after which the doctor observes how the heart and the nervous system responds to tilting. A tilt table test takes approximately one hour.
b. Electrophysiological Testing & Mapping
This test involves threading thin catheters (flexible tubes) fitted with electrodes via the blood vessels to several areas with a patient’s heart. This test is minimally invasive like a heart catheterization. The electrodes are used to map how electrical impulses spread through a patient’s heart. The electrodes can be used to stimulate the heart to trigger arrhythmia allowing the Electrophysiologist to identify the cause, location of arrhythmia, and ideal treatments.
The above information summarizes how to diagnose heart arrhythmia. Your doctor may subject you to one or more of the above tests before they have a final diagnosis. Once diagnosed, patients are given a treatment plan. Your doctor should discuss the test result and the treatment options available to you.
For more information on heart arrhythmia and its diagnostic tests, reach out to your local heart experts at Vital Heart & Vein. With advanced medical technology and unsurpassed expertise, we are dedicated to making a lasting impact on your heart health. Visit us online or schedule an appointment today.