Electrocardiogram is the most precise method for diagnosing the arrhythmia.
Sometimes an arrhythmia can be detected by listening to the heart with a stethoscope. However, the electrocardiogram is the most precise method for diagnosing the arrhythmia.
An arrhythmia may not occur at the time of the exam even though symptoms are present at other times. In such cases, tests will be done if necessary to find out whether an arrhythmia is causing the symptoms.
Testing for Arrhythmia
The health professional will consider the medical history of a patient and do a thorough physical exam. Then one or more tests may be used to check for an arrhythmia and to decide whether it is caused by heart disease. These tests may include:
Electrocardiogram (ECG or EKG). A record of the electrical activity of the heart. Disks are placed on the chest and connected by wires to a recording machine. The heart’s electrical signals cause a pen to draw lines across a strip of graph paper in the ECG machine. The doctor studies the shapes of these lines to check for any changes in the normal rhythm. The types of ECGs are:
- Resting ECG: The patient lies down for a few minutes while a record is made. In this type of ECG, disks are attached to the patient’s arms and legs as well as to the chest
- Exercise ECG (stress test): The patient exercises either on a treadmill machine or bicycle while connected to the ECG machine. This test tells whether exercise causes arrhythmias or makes them worse or whether there is evidence of inadequate blood flow to the heart muscle (“ischemia”)
- 24-hour ECG (Holter) monitoring: The patient goes about his or her usual daily activities while wearing a small, portable tape recorder that connects to the disks on the patient’s chest. Over time, this test shows changes in rhythm (or “ischemia”) that may not be detected during a resting or exercise ECG
Electrophysiologic study (EPS). A test for arrhythmias that involves cardiac catheterization. Very thin, flexible tubes (catheters) are placed in a vein of an arm or leg and advanced to the right atrium and ventricle. This procedure allows doctors to find the site and type of arrhythmia and how it responds to treatment.
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