Diagnosis of Arrhythmias (Heart Rhythm Disturbances)

Arrhythmias may be found during a routine exam. They may also be found while your heart is being tested for other reasons.

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:

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.


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

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

To send comments or feedback to our Editorial Team regarding the content please email us at healthlibrarysupport@ebsco.com. Our Health Library Support team will respond to your email request within 2 business days.