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Atrial Fibrillation Diagnosis

Atrial fibrillation is often first found when the pulse is checked at the time of an episode. To make an accurate diagnosis, an electrical recording of the heartbeat during atrial fibrillation is needed. This can be as simple as having an electrocardiogram (EKG) done in the doctor’s office, or using some type of heart monitor at home. Depending on the situation and how often suspected atrial fibrillation episodes may be occurring, different types of heart monitors may be recommended. These heart monitors include:

  • Holter monitor is used to give a detailed analysis of the heart’s electrical activity over a period of 24 hours (1 day). For this non-invasive test, which is done at home, 4 or 5 adhesive electrodes are placed on the chest and connected to an electrical recording device that is usually worn on the belt or on a neck/shoulder strap. This device records every heartbeat for the duration of the time that it’s worn.
  • Trans-telephonic heart monitor (“TTM” or “looping heart monitor”) is another similar non-invasive test that is done at home, usually over 7 to 30 days. During this test, 3 or 4 adhesive electrodes are placed on the patient’s chest and connected to a small device worn on the belt or around the neck. This device takes short electrical recordings whenever a button is pressed to indicate patient symptoms, and also whenever the device automatically detects an abnormality in the heart rhythm. The electrical recordings are wirelessly sent to the doctor’s office using a transmission device that is plugged into the wall as part of the TTM system.
  • Implantable heart monitor (“implantable loop recorder”) is a tiny device that is inserted under the skin in the center of the chest. This device is used when arrhythmias occur rarely and are not able to be detected on an EKG, 24-hour Holter or with a 30-day monitor. It is especially helpful when trying to determine whether an arrhythmia is responsible for a stroke or fainting spells. The implanted heart monitor communicates with a transmitter that is plugged into the wall, and sends electrical recordings to the doctor’s office whenever an arrhythmia is detected.