Testing & DiagnosisIn testing for an arrhythmia, the doctor may question the patient about conditions that trigger the arrhythmia. Arrhythmia-inducing tests may then be performed so that the arrhythmia can be diagnosed. Passive testing doesn't seek to trigger the arrhythmia, only to monitor the heart in its usual state.
- Stress test- Because some arrhythmias are triggered or made worse by physical stress, in this test the patient exercises on a treadmill or a stationary bicycle. If the patient is unable to exercise, the doctor will administer a drug that simulates the effect of exercise on the heart. In either case the heartbeat will be monitored by an EKG.
- Tilt-table test- This test is often given if the patient has had recurrent fainting spells. Heart rate and blood pressure are monitored while the patient lies flat on the table and as the table is tilted until he or she is fully upright. The doctor can monitor the physiological reactions of the heart to the lowering of blood pressure that occurs as the patient is tilted up.
- Electrophysiologic testing and mapping- Thin hoses (catheters) tipped with electrodes are guided through the blood vessels to different sites in the heart. The electrodes can then provide a map of the routes of the electrical impulses that flow through the heart. The electrodes can also be used to stimulate the heart to beat faster. This may trigger, or halt, an arrhythmia, and allows the doctor to observe its location and possible causes.
- EKGs- An EKG provides a record of the timing and duration of the electrical impulse pattern of the heartbeat. The doctor may want to record the heart's activity over a longer period of time. If so, the patient will need to use a Holter monitor, a portable EKG that is worn for a day or more. Another type of portable EKG is an event monitor, which is activated only when the patient experiences symptoms of an arrhythmia.
- Echocardiogram- This device uses sound waves to measure the heart and to produce a moving image of the beating heart.
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