An EKG can show heart rhythms that aren’t normal. A healthy heart will show a certain pattern. Rhythms that aren't normal will make a different pattern.

Heart Monitoring

Most arrhythmias come and go. They may not happen during testing. A device can be worn all day and night. It can be worn while someone goes about their normal day. This will increase the chance of catching the arrhythmia. This can be done with:

Holter monitor —A small machine is belted around the waist. It will record heart rhythm over 24 hours or more.
Transtelephonic monitoring —Data can be sent over the phone any time symptoms appear.
Implantable loop recorder —A device is placed under the skin in the chest. It will record all abnormal rhythms. The doctor can later collect the data. It may be used if the heart rhythm needs to be watched for a longer time.

Some arrhythmias may only appear when the heart is working hard. An exercise stress test tracks how your heart reacts to activity. Some people may not be able to do the exercise. In this case, medicine may be given to mimic exercise stress on the heart.

Tests to Look for Causes

Other tests may need to be done to look for a cause. The heart may be checked with:

Cardiac catheterization and coronary angiography—To help find blockages in the heart's arteries.
Chest x-ray—To see if the heart is enlarged or look for fluid buildup in the lungs.
Nuclear scanning —To look at the blood supply to the heart.
CT and MRI angiography—To look for blockage of blood flow.
Echocardiogram—To check the size, shape, and motion of the heart.

Other tests include:

Blood and urine tests —Used to check your general health. They can also find out how well your liver and kidneys are working.
Tilt table testing—This test is mainly used for people who faint. It can show if there is a problem keeping a healthy blood pressure when changing positions.
Electrophysiologic testing—To tests how the rhythm starts and moves through the heart.

References:

Arrhythmia. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/arrhythmia. Accessed January 2, 2019.

Atrial fibrillation screening. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated September 18, 2018. Accessed January 2, 2019.

Common tests for arrhythmia. American Heart Association website. Available at: https://www.heart.org/en/health-topics/arrhythmia/symptoms-diagnosis--monitoring-of-arrhythmia/common-tests-for-arrhythmia#.WTAdiOvytQJ. Accessed January 2, 2019.

Electrocardiogram (ECG). EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated November 7, 2018. Accessed January 2, 2019.

Symptoms & diagnosis. Heart Rhythm Society website. Available at: https://www.hrsonline.org/Patient-Resources/Symptoms-Diagnosis#axzz2wVpruTrZ. Accessed January 2, 2019.

Syncope—approach to the patient. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated July 31, 2018. Accessed January 2, 2019.

Wexler RK, Pleister A, Raman SV. Palpitations: evaluation in the primary care setting. Am Fam Physician. 2017;96(12):784-789.

Last reviewed December 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC
Last Updated: 1/2/2019

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