Alternativesto a heart rhythm study

There may be alternatives to heart rhythm studies.

For some people, the cause of a heart rhythm problem may be diagnosed with a less invasive and less expensive procedure. 

Diagnostic procedures

There are several less invasive diagnostic procedures that may be able to identify the cause of your arrhythmia. However, these procedures can only diagnose the problem. You may still need more invasive treatment. 

Less invasive alternatives to heart rhythm studies include:

Electrocardiogram

If your arrhythmia is happening frequently, your doctor may be able to diagnose it with an electrocardiogram (ECG). During an ECG, you lie on a table and a technician attaches electrodes to your chest with adhesive. Your skin may be shaved to make them stick. Wires connect the electrodes to the recording device.

Holter monitor

If your arrhythmia is intermittent, an ordinary ECG may not be able to capture it. A holter monitor is a portable ECG machine that records the activity of your heart over a period of 24 hours (or longer). At the cardiac clinic a technician attaches electrodes to your chest with adhesive. Wires connect the electrodes to the monitor device. You can wear the monitor like a shoulder bag or a pouch attached to your waist.

You can go about your normal activities, although you can’t bathe while you’re wearing it and some people find the electrodes irritating. The technician may give you a diary to record any symptoms you experience during the monitoring period. You go back to the clinic the next day where the technician removes the wires. Your doctor will analyse the data that’s been recorded and may be able to pinpoint the cause of your arrhythmia.

Tilt table testing

Your doctor may recommend tilt table testing if you have unexplained fainting spells (syncope), which may be caused by an arrhythmia. During tilt table testing, you’ll lie on a table with electrodes attached to your chest and a blood pressure monitor. The table is moved from a horizontal to a vertical position. The change in position may bring on the arrhythmia. You may also receive drugs through a vein to try and bring on your symptoms. 

Echocardiogram

An echocardiogram uses ultrasound to create a picture of your heart as it moves. It allows your doctor to see the size and shape of your heart and how it’s working. It may be used at the same time as other tests such as stress testing, which shows how your heart works when you exercise. A transoesophageal echocardiogram (or TOE) is a special type of echocardiogram where the doctor guides a probe down your throat and into your oesophagus (swallowing tube). This is done under sedation, so you don’t feel anything. It can provide more detailed pictures than a standard echocardiogram.

Implantable loop recorder

This procedure requires minor surgery to implant a small device under the skin of your chest. Your doctor may recommend this if you’re having palpitations or fainting spells that happen only occasionally. A loop recorder is about the size of a USB stick, or less. It can be left in place for up to 2 years.

Medication

If your doctors don’t think you’re a good candidate for a heart rhythm study, they may suggest starting you on medication to try and control the arrhythmia.