Types of Heart Monitors to Check for Arrhythmia

An arrhythmia is a distinct irregularity of the heartbeat. There are many types, according to the American Heart Association (AHA). Atrial fibrillation, which results in a weakened, quivering heartbeat, affects approximately 2.2 million Americans, according to the AHA. While some arrhythmias are harmless, others can be strong indicators of impending heart disease, stroke or fatal heart attack. Fortunately, many devices and tests can accurately diagnose arrhythmias.

Types

• Often, the first device a doctor uses to monitor a patient's heart is an electrocardiogram (EKG). According to the AHA, the Holter monitor is a more thorough method of producing an EKG reading. For those who don't experience arrhythmias every few days, a doctor may use a transtelephonic monitor, or event recorder. Other testing includes the treadmill test, the tilt table study, an electrophysiologic test, an esophageal electrophysiologic procedure and a transthoracic echocardiogram (TTE).

Noninvasive Procedures

• With an EKG, electrodes are placed onto various parts of the body to record electrical cardiac impulses while in the doctor's office. A Holter monitor is a portable EKG that can record electrical activity for up to 48 hours. A transtelephonic monitor is also used by a patient at home but only when an arrhythmia incident occurs. Some patients are asked to run or walk on a treadmill or ride a stationary bike while their heart activity is being recorded. The TTE is a detailed mapping of the heart through ultrasound.

Invasive Procedures

• The tilt table test records how a patient's heartbeat and blood pressure react when a person changes positions. An intravenous line and catheter are often inserted to give medications and monitor internal blood pressure. With electrophysiologic testing, a patient is given local anesthesia while electrode catheters are placed within the heart's atria, ventricles and other internal locations. An esophageal electrophysiologic procedure involves the insertion of a thin, flexible tube through the nostril and into the esophagus.

Analysis

• An EKG produces waves that document recorded impulses of the atria (upper chambers of the heart) and the ventricles (lower chambers of the heart). Through careful analysis of these waves, doctors can determine whether an arrhythmia is present. For a transtelephonic monitor, a patient simply transmits the recorded EKGs to the doctor via telephone. With electrophysiologic testing, electrodes record cardiac activity and effectiveness, often revealing the location of a blockage of the heart. A TTE patient is on his side while a cold gel is applied to the chest area and images of the heart in action are recorded through a device placed on the chest.

Details

• Many doctors ask patients who are using a Holter monitor to keep a journal of alarming symptoms and activities they experience throughout the day. This is helpful to the doctor when analyzing the results, which are pulled up on a computer for accurate and swift identification of irregularities. The treadmill test is for those who experience arrhythmias more during strenuous activity, while the tilt table study is for patients who experience frequent dizzy or fainting spells.

Effectiveness

• A person may have an arrhythmia problem but not experience one during a standard EKG. Electrophysiologic testing has been performed safely worldwide, according to the AHA, and the TTE has proven to be very effective. The electrophysiologic test provides more accuracy because it can show exactly where tachycardia (abnormally fast heartbeat) begins. With the use of both electrophysiologic procedures, doctors can purposefully start arrhythmias through electrical stimulation.