Comprehensive program in which heart rhythm is assessed using ECG and long-term monitoring in patients presenting with palpitations, fainting, or irregular pulse.
Indication
- Palpitations or sensation of irregular heartbeat
- Dizziness, fainting (syncope), or pre-syncope symptoms
- Atrial fibrillation (AF) or atrial flutter
- Supraventricular tachycardia (SVT) and ventricular arrhythmias
- Bradyarrhythmias (slow heart rate), AV block
- Screening for occult AF in patients with a history of stroke or transient ischemic attack
- Suspicion of inherited arrhythmia syndromes (long QT, Brugada, etc.)
Preparation
- Recording the onset, frequency, duration, and triggers of symptoms
- List of all medications and supplements being used
- Previous ECG, Holter, and ECHO recordings
- Blood tests for thyroid function, electrolytes, and complete blood count
How it's performed
- Detailed examination and review of symptoms
- Baseline rhythm assessment with a 12-lead ECG
- Continuous rhythm monitoring: 24-72 hour Holter, event recorder, or implantable loop recorder
- Echocardiography to screen for structural heart disease
- Exercise stress test for exercise-induced arrhythmias; electrophysiology study if needed
- Stroke and bleeding risk are calculated using CHA2DS2-VASc and HAS-BLED scores in atrial fibrillation
- Treatment plan: lifestyle measures, antiarrhythmic medications, anticoagulation with DOACs when indicated, catheter ablation, or permanent pacemaker
Post-procedure
- Early follow-up (2-4 weeks) for patients started on antiarrhythmic or anticoagulant therapy
- ECG every 3-6 months in stable patients, with Holter monitoring as needed
- Monitoring for bleeding signs and renal function in patients on DOACs or warfarin
- Three-month 'recovery period' followed by rhythm follow-up after catheter ablation
- Device checks (remote or in person) for patients with pacemakers or ICDs
Risks
- Proarrhythmic effects (new rhythm disturbance) of antiarrhythmic medications
- Bleeding risk associated with anticoagulant use
- Vascular injury, cardiac tamponade, or stroke during catheter ablation (rare)
- Infection or lead complications during pacemaker/ICD procedures
- Risk of stroke, heart failure, or sudden cardiac death in untreated arrhythmias
FAQ
Are palpitations always dangerous?
No. Most palpitations are benign, but they should be evaluated based on duration, accompanying symptoms, and the presence of underlying heart disease.
Why do I need blood thinners if I have atrial fibrillation?
AF can lead to clot formation in the atrium and cause stroke. If the CHA2DS2-VASc score is appropriate, direct oral anticoagulants (DOACs) significantly reduce the risk of stroke.
Is ablation a surgery?
No. Ablation is an interventional procedure in which the heart is reached via the blood vessels and the area causing the arrhythmia is neutralized with a catheter.
Do caffeine and alcohol trigger arrhythmias?
Excessive caffeine, alcohol, sleep disturbances, and stress can trigger arrhythmias in some individuals; reducing triggers is an important step in treatment.
Related Information
Related Medical Services
Other services in the same specialty or with similar indications you may want to explore.
Holter monitoring
Cardiology
Holter monitoring (24-hour ECG) — long-term recording of the heart rhythm during daily life.
Electrocardiography
Cardiology
Electrocardiography (ECG) — a painless and rapid recording of the heart's electrical activity.
Pacemaker Implantation and Follow-up
Cardiology
Permanent cardiac pacemaker implantation and regular pacemaker check-ups — treatment for bradyarrhythmias.
Echocardiography
Cardiology
Echocardiography (cardiac ultrasound) — sound-wave imaging of the heart chambers, valves, and pumping function.
Transesophageal Echocardiography
Cardiology
Transesophageal echocardiography (TEE) — detailed imaging of the heart structures from the esophagus.
Heart Failure Follow-Up
Cardiology
Heart failure follow-up — long-term monitoring with guideline-directed medical therapy and lifestyle measures.
Exercise Stress Test
Cardiology
Exercise stress test — evaluation of electrocardiographic changes under increased cardiac workload during exertion.
Coronary Angiography
Cardiology
Coronary angiography — imaging and evaluation of the heart vessels using a catheter.