Arrhythmia : Tests & Treatment

The following tests may normally be performed to identify arrhythmias:

  1. Ambulatory cardiac monitoring with a Holter monitor (used for 24 hours), event monitor, or loop recorder (worn for 2 weeks or longer)
  2. Coronary angiography
  3. ECG
  4. Echocardiogram
  5. Electrophysiology study (EPS)

If an arrhythmia is detected, various tests may be done to confirm or rule out suspected causes. EPS testing may be done to find the arrhythmia and determine the best treatment.

When an arrhythmia is serious, urgent treatment may be required to restore a normal rhythm. This may include:

  1. Electrical “shock” therapy (defibrillation or cardioversion)
  2. Implanting a temporary pacemaker to interrupt the arrhythmia
  3. Medications given through a vein (intravenous)

Supraventricular arrhythmias may be treated with:

  1. Medications that slow the pulse (beta blockers, calcium channel blockers)
  2. Medications that cause the heart rhythm to return to normal (anti-arrhythmic drugs)

Many supraventricular arrhythmias can be treated and cured with radiofrequency ablation. This avoids the need for lifelong drug therapy.
Increasingly, most ventricular tachycardias are treated with an implantable cardioverter-defibrillator (ICD). As soon as arrhythmia begins, the ICD sends a shock to stop it, or a burst of pacing activity to override it.
Bradycardias that cause symptoms can be treated by implanting a permanent pacemaker.

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