What tests are done for arrhythmia?

Written by Wang Li Bing

Intensive Care Medicine Department

Updated on March 25, 2025

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Arrhythmia is also relatively common in clinical practice, and its common detection method is mainly the electrocardiogram (ECG). ECG is a simple and non-invasive operation that helps to identify the type of arrhythmia. Another method is the 24-hour Holter monitor, which can record all heart rate changes occurring within 24 hours. If an arrhythmia occurs, it is crucial to seek medical attention promptly, visiting a cardiology department. Treatment may involve antiarrhythmic medications, and if possible, a complete electrophysiological examination can be performed.

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Written by Zhou Yan

Geriatrics

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Can arrhythmia be cured?

There are many types of arrhythmia, some of which, like sinus tachycardia, sinus bradycardia, occasional premature atrial contractions, premature ventricular contractions, and premature junctional contractions, can also occur in healthy individuals and usually do not require treatment. Another category requires treatment, such as supraventricular tachycardia, including atrioventricular nodal reentrant tachycardia, which can be cured by radiofrequency ablation. Additionally, conditions like atrial fibrillation can be treated with radiofrequency ablation; many patients may be cured, but some may not respond to this treatment and require medication instead. There are also patients with intrinsic structural heart disease presenting various arrhythmias that can only be managed with medication, not cured.

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Written by Chen Ya

Geriatrics

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Arrhythmia is caused by what?

Arrhythmia is caused by abnormal excitation of the sinoatrial node or excitation originating outside the sinoatrial node, with slow conduction, blockage, or conduction through abnormal pathways. This results in the frequency and (or) rhythm abnormalities of heartbeats, which are collectively referred to as arrhythmias. Most of the causes include the following: one is genetic arrhythmias, often due to gene channel mutations, such as the commonly seen long QT syndrome, short QT syndrome, Brugada syndrome, etc. There are also acquired arrhythmias, seen in various organic heart diseases, including coronary atherosclerotic heart disease, commonly referred to as coronary heart disease, cardiomyopathy, myocarditis, and rheumatic heart disease, particularly prevalent during heart failure or acute myocardial infarction. Arrhythmias are also not uncommon in basically healthy individuals or patients with autonomic dysfunction. Other causes include electrolyte imbalance or endocrine disorders, and sometimes anesthesia, hypothermia, or surgery, such as thoracic or cardiac surgery, or medications, central nervous system diseases may also cause arrhythmias, but the specific reasons are not very clear.

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Written by Wang Li Bing

Intensive Care Medicine Department

42sec

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What is ventricular arrhythmia?

Ventricular arrhythmias mainly refer to disorders of the ventricular rhythm and are relatively common clinically, including premature ventricular contractions, ventricular tachycardia, ventricular flutter, and ventricular fibrillation. Premature ventricular contractions generally do not cause noticeable clinical symptoms, while ventricular flutter and ventricular fibrillation are very dangerous clinically and must be treated promptly with defibrillation. Therefore, ventricular arrhythmias must be treated promptly, actively treating the underlying disease, and managing the arrhythmia to prevent sudden death.

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Geriatrics

58sec

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Does arrhythmia require hospitalization?

Arrhythmia treatment should be determined based on the patient's symptoms, type of arrhythmia, and its impact on hemodynamics. For instance, minor conditions like slight sinus bradycardia, irregular sinus rhythm, occasional atrial premature contractions, and first-degree atrioventricular block, which have minimal impact on hemodynamics and no significant clinical manifestation or structural heart disease, do not necessitate hospitalization. However, more severe arrhythmias such as sick sinus syndrome, rapid atrial fibrillation, paroxysmal supraventricular tachycardia, and sustained ventricular tachycardia, which can cause symptoms like palpitations, chest tightness, dizziness, low blood pressure, sweating, and in severe cases, fainting, Adam-Stokes syndrome, and even sudden cardiac death, require prompt medical attention and hospitalization for treatment.

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Written by Chen Ya

Geriatrics

1min 33sec

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What tests are done for arrhythmia?

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.