Arrhythmia Monitoring

         Basic Facts

  • Arrhythmia monitoring refers to tests physicians use to identify the type and the cause of irregular heart rhythms, which may feel as if the heart were beating quickly, fluttering or skipping a beat. 
  • Arrhythmias are caused by problems with the heart’s electrical system that alter the formation of the electrical impulse that initiates a heartbeat or disrupt the pattern of conduction that distributes the impulse through the heart.
  • Arrhythmias are common, especially as people age. Many arrhythmias are harmless, but some arrhythmias are extremely dangerous and require treatment and management. 

Arrhythmias often are classified by their location in the heart. An atrial or supraventricular arrhythmia occurs in one of the two upper chambers of the heart, the left or right atrium. Ventricular arrhythmias originate in the ventricles, the lower chambers of the heart, and can interfere with the heart’s ability to pump blood to the body. 

One way that physicians monitor arrhythmias is by using electrocardiography (ECG). There are three forms of ECG testing, which are used to assess the heart’s electrical activity under different circumstances:

  • Resting ECG – This test is usually performed while a patient lies on a table,
  • ECG stress test – The stress test monitors a heartbeat during exercise, most commonly while a person walks on a treatmill.
  • Ambulatory ECG  - Many arrhythmias occur infrequently. To record the heart’s electrical activity under real-world conditions, physicians use continuous monitor recording, also called ambulatory electrocardiography. This test records the electrical activity of the heart while a patient does usual activities. For example, the patient may wear a Holter monitor, a battery-operated portable device that measures heart activity continuously for 24 hours, or several days, or even weeks.
Physicians also use electrophysiology (EP) testing to diagnose arrhythmias. EP testing examines the electrical function of the heart from inside the heart itself using catheters (thin, flexible tubes). 

Resting ECG and ECG stress tests typically are used for arrhythmias that occur frequently, and ambulatory ECG is used for infrequent arrhythmias.

Arrhythmia Monitoring FAQ