What tests are done for arrhythmia?

Written by Chen Ya
Geriatrics
Updated on September 02, 2024
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The examinations required for arrhythmia are as follows: First, an electrocardiogram, which is the most important non-invasive diagnostic technique for diagnosing arrhythmias. Second, a Holter monitor test should be conducted, which records the electrocardiogram continuously over 24 hours to possibly capture the occurrence of symptoms such as palpitations and fainting, and whether they are related to arrhythmias. It clarifies the relationship between arrhythmias or myocardial ischemia attacks and daily activities, as well as their diurnal distribution characteristics, and can assist in evaluating the efficacy of medications and the condition of pacemakers to some extent. Third is the exercise test; if palpitations occur during exercise, an exercise test can assist in making a diagnosis. Fourth is the esophageal electrocardiogram, which is a useful non-invasive method for diagnosing arrhythmias. Fifth is the cardiac electrophysiological study, typically involving the placement of electrode catheters on the upper and lower parts of the right atrial wall, the tip of the right ventricle, the coronary sinus, and the His bundle area, with the electrical activity at these sites being simultaneously recorded using a multi-channel physiological recorder with 8-12 channels or more.

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Written by Chen Ya
Geriatrics
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How to relieve arrhythmia

The relief of arrhythmia mainly involves removing any triggers if they exist, as well as using non-pharmacological methods, including ocular compression, carotid sinus massage, pinching the nose and forcefully exhaling, and breath-holding, which are methods to reflexively stimulate the vagus nerve. If relief is unachievable and the episodes are accompanied by hypotension, fainting or near-fainting, seizures, angina, or heart failure, it is crucial to seek medical attention promptly for pharmacological interventions against arrhythmias, or even consider electrical treatments such as cardioversion, defibrillation, pacemaker implantation, and ablation, as well as surgical options.

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Written by Wei Shi Liang
Intensive Care Unit
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Ventricular arrhythmias include the following types.

Common ventricular arrhythmias mainly include premature ventricular contractions, ventricular tachycardia, ventricular flutter, and ventricular fibrillation. Premature ventricular contractions appear on the electrocardiogram as prematurely occurring wide and abnormal QRS complexes. If asymptomatic, no treatment is needed; if symptomatic, receptor blockers can be used for treatment. Ventricular tachycardia is clearly indicated on the electrocardiogram by wide and abnormal QRS complexes, with heart rates ranging from 140 bpm to 200 bpm. The primary treatment is to remove the cause, and electrical cardioversion can be used when hemodynamics are unstable. Ventricular flutter and fibrillation, their ventricular rates are generally above 250 bpm, and treatment is crucial.

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Written by Chen Ya
Geriatrics
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Can arrhythmia cause sudden death?

The clinical manifestations of hemodynamic changes caused by arrhythmias mainly depend on the nature, type, cardiac function, and the extent of impact on hemodynamics. Mild conditions such as slight sinus bradycardia, sinus arrhythmia, occasional atrial premature contractions, and first-degree atrioventricular block have minimal impact on hemodynamics and therefore do not exhibit significant clinical manifestations, and sudden death is generally not expected. However, more severe arrhythmias, such as sick sinus syndrome, rapid atrial fibrillation, paroxysmal supraventricular tachycardia, and sustained ventricular tachycardia, can lead to palpitations, chest tightness, dizziness, hypotension, and sweating. In severe cases, syncope, Adams-Stokes syndrome, or even sudden death may occur.

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Written by Chen Ya
Geriatrics
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How to treat arrhythmia?

The treatment of arrhythmias should be based on the symptoms of the patients with arrhythmias, the type of arrhythmias, and their impact on hemodynamics. Control of arrhythmias during episodes involves removing the cause and focus of the disease and preventing recurrence, which can be divided into non-pharmacological and pharmacological treatments. Non-pharmacological treatments include methods such as eyeball compression, carotid sinus massage, pinching the nose to exhale forcefully and hold breath to reflexively excite the vagus nerve, along with electrical treatments like electrical cardioversion, defibrillation, pacemaker implantation, and ablation surgery. There are mainly four types of drugs used: sodium channel blockers; beta-adrenergic blockers; drugs selectively prolonging the repolarization process, such as amiodarone; and calcium channel blockers. However, long-term use of these antiarrhythmic drugs can have varying degrees of side effects, and severe cases can cause ventricular arrhythmias or cardiac conduction block which can be fatal. Therefore, in clinical application, it is essential to strictly control the indications, monitor for adverse reactions, and rigorously follow the doctor's orders.

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Written by Chen Ya
Geriatrics
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Arrhythmia is what kind of disease

Arrhythmia is caused by abnormal excitation of the sinoatrial node or excitation originating outside the sinoatrial node, where the propagation of excitation is slow, blocked, or conducted through abnormal channels, leading to abnormalities in the frequency and/or rhythm of heartbeats due to origins and (or) conduction disorders of cardiac activity. Arrhythmia is an important group of diseases within cardiovascular diseases. It can occur independently or in conjunction with other cardiovascular diseases. Its prognosis is related to the causes, inducing factors, and evolutionary trends of the arrhythmia, and whether it leads to severe hemodynamic disturbances. It can cause sudden death or continuously affect the heart leading to its failure.