First the doctor will take a medical history 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.
The doctor should also include questions about diet in the exam. If ingestion of large ammounts of caffeine is evident then elimination of these from the diet may alleviate the problem.
Tests for Detecting Arrhythmias
- 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.
- Transtelephonic monitoring. The patient wears the tape
recorder and disks over a period of a few days to
several weeks. When the patient feels an arrhythmia, he
or she telephones a monitoring station where the record is
made. If access to a telephone is not possible, the
patient has the option of activating the monitor's memory
function. Later, when a telephone is accessible, the
patient can transmit the recorded information from the
memory to the monitoring station. Transtelephonic
monitoring can reveal arrhythmias that occur only once
every few days or weeks.
- 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.
- 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.
How are arrhythmias treated?
Many arrhythmias require no treatment whatsoever.
Serious arrhythmias are treated in several ways depending on what is causing the arrhythmia. Sometimes the heart disease is treated to control the arrhythmia. Or, the arrhythmia itself may be treated using one or more of the following treatments.
How can arrhythmias be prevented?
If heart disease is not causing the arrhythmia, the doctor may suggest that you avoid what is causing it. For example, if caffeine or alcohol is the cause, the doctor may ask you not to drink coffee, tea, colas, or alcoholic beverages.
