Diagnosing arrhythmias

Arrhythmias can be documented by a regular ECG performed in the emergency room or doctor’s office when the person is experiencing symptoms. Patients who have daily episodes of arrhythmia can have a 24-hour Holter monitor placed to document which arrhythmia is present. More commonly, patients may have less frequent – for instance, monthly – episodes and can use an external event monitor to record their heart rhythm by holding the monitor to their chest and pressing a button.

An ECG is essential in diagnosing the type of arrhythmia

Using an event monitor

The event monitor records an ECG and stores it in memory. The person can then call a toll-free telephone number and the device will turn the ECG into sound waves and send them over the phone. The technician on the other end of the phone has a machine that turns the sound waves back into an ECG that can be printed out and faxed to the doctor to see which arrhythmia is present.

Recording rarer occurrences

Episodes that occur more rarely (for example, on yearly basis) are difficult to document unless the person waits until an episode occurs and then seeks medical attention at an emergency room or physician’s office. Persons who call 911 may have their episode of arrhythmia documented by the paramedics who can perform an ECG en route to the hospital. Persons who are in the hospital wearing a telemetry monitor when the arrhythmia occurs may have it documented in that way.

Internal looped monitors

Internal looped monitors may be deployed to document arrhythmias when other means fail. These devices are implanted under the skin and are capable of automatically recording an ECG if an arrhythmia occurs. Also, the patient can activate the device if an arrhythmia occurs. The device is continuously recording the person’s rhythm with a looped memory. If the person activates the device, it freezes the memory buffer, which contains the previous 5 minutes of the person’s rhythm and, usually, the arrhythmia. The person can then visit their doctor’s office, and the nurse can place a communicating wand on the skin over the device and retrieve the rhythm information. All of these methods give the doctor a good idea about what is going on, but the definitive diagnosis may require an electrophysiology (EP) study to see what arrhythmias can be induced in the patient.