Detecting Arrhythmias: What Every Patient Should Know

This article is for people who are at risk for arrhythmias (irregular heart rhythms) or are having palpitations (a fast heartbeat), or anyone who wants to learn more about arrhythmias. The goal of this patient education activity is to learn about different devices that can help detect, or find, arrhythmias.

You will learn about:

• What an arrhythmia is and how it's linked to stroke

• What can cause arrhythmias

• How to know if you have an arrhythmia

• Devices that can help monitor heart rhythm and detect arrhythmias

An arrhythmia is an irregular heart rhythm that happens when the electrical signals in your heart don't work correctly. This can affect how your heart beats and how blood flows through the heart.

When blood isn't flowing through your heart properly, blood clots can form. Having an arrhythmia can increase your risk or chance of a blood clot forming and traveling from your heart to other parts of your body.

Atrial fibrillation (AF) is a common type of arrhythmia that increases the risk of having a blood clot form and travel to the brain, which can cause a stroke.

An arrhythmia can be caused by triggers and risk factors. Triggers can include stress, smoking, or drinking too much caffeine or alcohol. Avoiding triggers can help lower your chances for an arrhythmia.

Risk factors are related to your genetics or overall health and can include being 65 or older, being female, your race or ethnicity, and having health conditions such as:

• Diabetes

• High blood pressure

• Obesity or overweight

• Sleep apnea, where your breathing stops and starts while you sleep

• Heart or kidney disease

• Heart failure

• Previous heart attack or stroke

• Thyroid disease

There are different types of arrhythmias, which can make it hard to diagnose or find out which one you may have.

Some arrhythmias:  

• Make your heart beat too fast, too slow, and/or irregularly

• Cause symptoms like tiredness, weakness, feeling uncomfortable, or having palpitations

• Don't cause any symptoms

• Happen once in a while (intermittently), while others can happen frequently and can become permanent

• Last only 30 seconds, while others can last more than 24 hours

• Can lead to stroke or death

There are devices that can monitor your heart rhythm and detect arrhythmias. The type of device that your doctor recommends will be based on your symptoms, how long they last, and how severe they are. If you don't have symptoms, it will be based on your overall health and risk factors.

Once your doctor diagnoses what type of arrhythmia you have, you can make your treatment plan together.

An electrocardiogram (ECG) is a test you have in a doctor's office, clinic, or hospital that uses a device to monitor your heart rhythm for 30 seconds.

Small patches on your chest called electrodes transmit your heart's electrical activity to an ECG device by wires. An ECG report then tells your doctor how fast your heart is beating, if the rhythm is steady or irregular, and how well blood is flowing through your heart.

An ECG can diagnose an arrhythmia if you have one while you're having the test, but that doesn't happen in many cases.

A Holter monitor works similarly to an ECG test except that the heart's electrical signals get transmitted back to a small, portable device. It can record heart rhythm continuously (nonstop) for 1 to 2 days while you're at home, at work, or doing light daily activities.

A Holter monitor may be helpful if you have symptoms like palpitations every day or every 2 days. There are also Holter monitors that can record heart rhythm for 1 to 2 weeks, as well as other portable devices that can record up to 1 month.

Wearable devices can be worn on your body and monitor your heart rhythm continuously for up to 1 month. They can come as small patches that are placed on your chest or as a garment that you can wear under your clothes.

Some of these devices come with features such as real-time alerts that can notify a call center if you're having an arrhythmia.

An insertable cardiac monitor (ICM) is a very small device that is placed under your skin close to your heart and can monitor your heart rhythm continuously for 1 year or more.

A doctor who specializes in heart rhythms, called an electrophysiologist, can insert the device in the doctor's office. You'll get a local anesthetic (medicine injected to numb the area) first. Itching and infection at the spot where the device was inserted are possible.

With ICM, doctors can monitor your heart rhythm from the office. An ICM can help find an arrhythmia in someone who has symptoms like palpitations that don't happen often enough to be recorded by a 24-hour or 1-month monitoring device.

Some smartwatches, smartphones, or digital health apps and devices can also monitor heart rate. The information collected can be helpful but is not the most accurate, because there will be times when the device is not always with you.

Also, unlike the ECG, Holter monitor, wearable technology, and ICM, which are regulated by the US Food and Drug Administration (FDA), most digital health devices are not regulated. So they are not as reliable. Talk to your doctor if you have any questions about using digital health devices.

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Arrhythmia

Atrial Fibrillation

Atrial Stroke