Last updated: 11/24/2009

Diagnosis of abnormal heart rhythms

A doctor may be able to detect an irregular heartbeat during a physical exam by taking the patient's pulse. In addition, the diagnosis may be based upon the presence of certain symptoms, including:

• palpitations...
  
  (feeling of skipped heartbeats or fluttering in the chest)
• pounding in the chest
• shortness of breath
• chest discomfort
• fainting
• dizziness or feeling light-headed
• weakness, fatigue, or feeling tired

Not everyone with abnormal heart rhythms will experience symptoms, so the condition may be discovered upon examination for another medical condition.

DIAGNOSTIC TESTS. Tests used to diagnose an abnormal heart rhythm or determine its cause include:

• blood tests
• chest x rays
• electrocardiogram
• ambulatory monitors such as the Holter monitor, loop recorder, and trans-telephonic transmitter
• stress test
• echocardiogram
• cardiac catheterization
• electrophysiology study (EPS)
• head-upright tilt table test
• nuclear medicine test such as a MUGA scan (multiplegated acquisition scanning)

Preparation

During a preoperative appointment, usually scheduled within one to two weeks before surgery, the patient will receive information about what to expect during the surgery and the recovery period. The patient will usually meet the cardiologist, anesthesiologist, nurse clinicians, and surgeon during this appointment or just before the procedure.

Medication to thin the blood (blood thinner or anticoagulant) is usually given for at least three weeks before the procedure.

If the patient develops a cold, fever, or sore throat within a few days before the surgery, he or she should notify the surgeon's office.

From midnight before the surgery, the patient should not eat or drink anything.

The morning of the procedure, the patient should take all usual medications as prescribed, with a small sip of water, unless other instructions have been given. Patients who take diabetes medications or anticoagulants should ask their doctor for specific instructions.

The patient is usually admitted to the hospital the same day the surgery is scheduled. The patient should bring a list of current medications, allergies, and appropriate medical records upon admission to the hospital.

The morning of surgery, the chest area is shaved and heart monitoring begins. The patient is given general anesthesia before the procedure, so he or she will be asleep during the procedure.

The traditional Maze procedure takes about an hour to perform, while the surgical pulmonary vein isolation procedure generally takes only a few minutes to perform. However, the preparation and recovery time add a few hours to both procedures. The total time in the operating room for each of these procedures is about three to four hours.