How are Heart Arrhythmias Diagnosed? - Crozer-Keystone Health System - PA

Published on October 21, 2015

How are Heart Arrhythmias Diagnosed?

Every single heartbeat is triggered by a group of cells in the heart. These cells generate electrical impulses that spread over the heart and make it contract. However, when these electrical impulses don’t work properly, it can cause your heart to beat too fast, too slow or irregularly – a condition called heart arrhythmias.

An arrhythmia may feel like a fluttering or racing heart. It may be harmless, but some heart arrhythmias may cause troublesome or even life-threatening symptoms, making treatment crucial.

But before doctors can begin treating an arrhythmia, they have to properly diagnose it. This starts with a heart monitor.

"If someone passes out and we don't know why, we're worried that it's from a bradyarrhythmia, from a slow heart rate. (If) the monitors don't reveal any useful information and then we move on to putting in the implantable monitor,” said David Kleinman, M.D., the director of Crozer-Keystone Health System’s Electrophysiology Laboratory.

An implantable cardiac heart monitor that is injected underneath the skin is just one way doctors can determine if a patient has an arrhythmia. According to Dr. Kleinman, this device is smaller than a paperclip and inserting it takes about five minutes under local anesthesia in an outpatient procedure.

When one of these devices is implanted, doctors may find the symptoms the patient has been experiencing are not due to an arrhythmic reason, which is also important information.

“If it's from the heart, we can usually do something about it to prevent any further episodes, such as implant a pacemaker,” Dr. Kleinman said. “Or sometimes we can do a catheter-based procedure, sometimes we can use medications. The important thing is to make the diagnosis and this device helps us make the diagnosis.”

The way the implantable device works is by recording the heart rhythm.

“It’s like an EKG all the time or a heart monitor all the time,” he said. In addition to the device getting injected under the skin, the patient is also given a monitor to keep by their bedside.

“Every time the patient passes by the monitor, information is uploaded from the device to a central monitoring station that's manned 24 hours a day,” he said.

The device gives doctors the ability to catch arrhythmias as they happen.

“Usually it's not an emergency but [sometimes] it is…and the on-call doctor gets notified,” he said of a serious arrhythmia. “We have the capability to follow up on the monitor and act on it all at once.”

Once an arrhythmia is determined to be the cause of the fluttering or racing heart symptoms, treatment can be administered to control or eliminate fast or irregular heartbeats.

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