Diagnosis of Atrial Fibrillation

The first step in finding an atrial fibrillation cure is to accurately diagnose the problem. To determine whether or not you have atrial fribrillation or to assess the severity of your condition, your diagnosis will begin with a history and physical exam.

Talk with your doctor about how you are feeling, prior medical conditions, and medications you are taking. Make sure to include over-the counter medications, vitamins or supplements. The physical exam will include blood pressure, pulse and listening to your heart and lungs.

Your doctor may order one or more of the following:

Lab tests: Your doctor will need to know what has been happening with your body’s chemistry and if there is underlying reasons for a rapid or irregular heart rate in order to find an atrial fibrillation cure. For example, sometimes the thyroid makes too much of a special hormone, causing your heart to race.

Electrocardiogram (EKG or ECG): This will record the electrical activity of your heart. Small, sticky patches called electrodes are placed on your chest, arms and legs. Wires connected to these patches carry 12 different views of the heart’s electrical signal to a machine that makes a tracing onto paper.

Echocardiogram: This test uses ultrasound waves to make a moving picture of your heart on a video screen, showing your doctor the size, shape and movement of your heart valves and heart walls. This test can help show if your A-Fib is related to valvular disease.

Nuclear Stress Testing:    A test to evaluate your heart in two different ways, making it more accurate. This test measures blood flow to your heart at rest and while your heart is working harder as a result of exertion or medication. This test provides images that can show areas of low blood flow through the heart and damaged heart muscle. Based on body habitus, this test is completed over one or two days

Stress Electrocardiogram: This is an EKG of your heart while it is at work. Usually this is done on a treadmill, but sometimes a medication is given to mimic the effects of exercise. Stress testing evaluates how the heart responds to an increase in work. When this test is performed to measure your heart activity before and after you start exercise it is called a stress echocardiogram.

Holter Monitor: This is a portable EKG monitor that records the heart’s rhythm during the time it is worn. Irregular heart rhythm problems may come and go, making it difficult for the doctor to know what is happening with your heart. This monitor is usually worn for 24-48 hours and shows any abnormal heart rhythm that would occur while you go about your daily activities. You will be asked to keep a diary to track your symptoms and daily activities so the doctor can link them with any irregular heart rhythm to help find an atrial fibrillation cure.

Loop Recorder: A tiny insertable monitor, about one third the size of a AAA battery, can be placed just under the skin.  A small bedside unit collects the heart rhythm data from the monitor and sends it to your doctor. The system detects abnormal heart rhythms for up to three years.

Event Monitor: A small portable EKG recorder about the size of a deck of cards that can be worn for 2-4 weeks. When you have symptoms that may be related to your heart rhythm, a button is activated and a recording is made of your heartbeat. Patients are given a telephone number to call so that tracings can be transmitted over the telephone.

Transesophageal Echocardiogram (TEE): An ultrasound probe is passed from your mouth to your esophagus. This tube lies next to the heart, allowing very good pictures of the heart to be taken. This test can assess the overall function of your heart’s chambers and valves. A TEE can also determine if there is a clot in the left atrial appendage. The information helps the doctor decide if it is safe to try to get your heart into a normal rhythm. You will receive sedation for this procedure, so plan on having someone drive you home afterwards. The test generally lasts 90 minutes.

Electrophysiology Study (EP study or EPS): An electrophysiology (EP) study is a test performed in the heart catherization lab by an Electrophysiologist. The procedure involves inserting a catheter (a narrow, flexible tube) attached to monitoring electrodes through blood vessels and into the heart. The electrodes tell the doctor where the electrical signals begin in the heart, and how often they are sent. With this study, rhythm problems can be identified, giving the doctor better information to decide what can be done to control or correct your irregular heart rhythm and find an atrial fibrillation cure.