TESTS AND PROCEDURES
A 12-lead electrocardiogram (ECG) is the most common method for examining a patient’s heart rhythm and can provide the best information on the presence and type of cardiac arrhythmia . This is the same procedure as a ‘normal’ ECG which is routinely conducted by a general practitioner or cardiologist. If the rhythm disorder can be documented using the 12-lead ECG, this provides an ideal starting point to plan further treatment. Using the ECG, it is possible to distinguish between rhythm abnormalities arising from the ventricles and those from the atria. In combination with other diagnostic procedures, such as a cardiac ultrasound (ECHO), it is frequently possible to determine whether rhythmic disorders are malignant, which may be potentially life-threatening, or benign heart rhythm abnormalities.
Long-term ECG (holter monitor test) and cardiac event recorder
Many arrhythmia occur infrequently and for only brief episodes. Depending on how frequently the abnormality occurs, e.g. if the arrhythmia is experienced daily, it may be useful to carry out a long-term ECG. If the abnormal rhythms occur less frequently, small portable ECG recording devices, known as cardiac event recorders, are available, which patients can carry with them. The event recorder is placed on the chest as soon as the rhythm abnormality occurs and can record a short ECG section. Fainting (also known as syncope) can be a warning sign of a heart condition which requires treatment. A cardiovascular examination is usually required to clarify the cause. If this initial evaluation indicates the presence of a cardiac arrhythmia, an ECG recording device can be implanted under the skin, which can record rhythm abnormalities when they occur, or which can be activated by the patient following a fainting episode.
Stress Test ECG
Since some cardiac arrhythmia occur primarily under physical strain, it can sometimes be helpful to perform an ECG recording during physical exercise. For this purpose, a stress test ECG is used, similar to the examination for stress-dependent blood flow problems in the heart muscle. During a stress test, the patient uses an exercise bike to the point of maximal exertion, while an ECG is performed and blood pressure measured at regular intervals.
Prior to an appointment for a stress test, you should, following consultation with your general practitioner, not take any medication that slows your heart rhythm (e.g. so-called betablockers).
If preliminary examinations indicate the presence of a cardiac arrhythmia, an electrophysiological examination is often necessary for further clarification. This is a heart catheter examination in which the electrical properties of the heart are measured and deviations can be detected. The sections of the heart in which the disorder originates or which are responsible for causing palpitations can be localised and often treated directly.