Arrhythmia Evaluation & Management
An occasional skipped beat is common and usually harmless. What matters is a rhythm that is fast and completely irregular, one that comes with dizziness or chest discomfort, or one that keeps returning. The difficulty is catching it, which is why most of this work is done with monitors worn at home.
- ECG and Holter monitoring on site
- Monitors worn during ordinary life
- Stroke risk assessed, not just rhythm
- Pacing available where the rate is too slow
Stay
Outpatient in most cases
Duration
Monitoring worn for 24 hours to several days
Anaesthesia
Not applicable for assessment
About Arrhythmia Evaluation & Management
Palpitations are hard to investigate because they rarely happen during an appointment. A standard ECG catches the rhythm only if it is occurring at that moment, so monitoring worn for a day or several days is usually the answer. Once the rhythm is identified, treatment depends on which one it is. For atrial fibrillation in particular, assessing and reducing stroke risk matters as much as controlling the rate.
- A normal ECG does not rule out a rhythm problem
- Monitoring worn at home is what usually makes the diagnosis
- Atrial fibrillation raises stroke risk, which is treatable
- Some slow rhythms need a pacemaker rather than medication
Before you read on
Everything here is general information about arrhythmia evaluation & management. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest arrhythmia evaluation & management.
- Palpitations lasting more than a few minutes or recurring
- An irregular pulse noticed by you or a doctor
- Dizziness, blackouts or near-fainting
- Palpitations with chest discomfort or breathlessness
- A known rhythm disorder needing review
Procedure details
The usual sequence, from first consultation through to follow-up.
Consultation and ECG
A history of what the palpitations feel like, when they happen and how long they last, with an ECG recorded at the visit.
Monitoring at home
A Holter monitor or longer recorder is fitted and worn during ordinary activity, so the rhythm is captured when it actually happens.
Assessment of the heart
An echocardiogram and blood tests look for an underlying cause, including thyroid problems and structural heart disease.
Treatment
Depending on the rhythm, treatment may be medication, blood thinning to reduce stroke risk, a pacemaker, or referral for an ablation procedure.
How to prepare
What to sort out before you come in.
- Keep a note of when palpitations happen, how long they last and what you were doing
- Note any caffeine, alcohol or medication that seems to trigger them
- Bring previous ECGs and thyroid results if you have them
- Wear a loose top on the day a monitor is fitted
- Do not stop any heart medication before your appointment
Recovery
What to expect afterwards, and roughly when.
- Wearing a monitor does not restrict normal activity apart from bathing
- Keep the diary the monitor comes with, since matching symptoms to the trace is what makes it useful
- If a blood thinner is started, take it exactly as prescribed
- Report blackouts or worsening dizziness immediately rather than waiting
- Follow-up is arranged once the monitor has been analysed
Why choose Humayun for rhythm problems
The whole difficulty with palpitations is catching them, and that depends on the monitoring being easy to arrange.
- ECG, Holter and ambulatory monitoring arranged from the first appointment rather than referred elsewhere
- Echocardiography on site to check for a structural cause
- Stroke risk assessed and treated, not just the heart rate
- Temporary and permanent pacing available in the same unit for rhythms that are too slow
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