What tests are done for arrhythmia?

Written by Chen Ya
Geriatrics
Updated on September 02, 2024
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The examinations required for arrhythmia are as follows: First, an electrocardiogram, which is the most important non-invasive diagnostic technique for diagnosing arrhythmias. Second, a Holter monitor test should be conducted, which records the electrocardiogram continuously over 24 hours to possibly capture the occurrence of symptoms such as palpitations and fainting, and whether they are related to arrhythmias. It clarifies the relationship between arrhythmias or myocardial ischemia attacks and daily activities, as well as their diurnal distribution characteristics, and can assist in evaluating the efficacy of medications and the condition of pacemakers to some extent. Third is the exercise test; if palpitations occur during exercise, an exercise test can assist in making a diagnosis. Fourth is the esophageal electrocardiogram, which is a useful non-invasive method for diagnosing arrhythmias. Fifth is the cardiac electrophysiological study, typically involving the placement of electrode catheters on the upper and lower parts of the right atrial wall, the tip of the right ventricle, the coronary sinus, and the His bundle area, with the electrical activity at these sites being simultaneously recorded using a multi-channel physiological recorder with 8-12 channels or more.

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Written by Zhang Yue Mei
Cardiology
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Symptoms of Sinus Arrhythmia

Symptoms of sinus arrhythmia vary according to different causes, including sinus bradycardia, sinus tachycardia, sinus arrhythmia, sinus arrest, and sick sinus syndrome. Mild cases of sinus bradycardia, sinus tachycardia, and arrhythmia generally do not present noticeable clinical symptoms. However, severe cases can experience symptoms such as palpitations, fatigue, and shortness of breath. Sinus arrest and sick sinus syndrome often present more severe clinical symptoms, including not only shortness of breath but also dizziness, blackouts, fainting, and acute cerebral ischemia and hypoxia.

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Written by Chen Ya
Geriatrics
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What medicine is used for arrhythmia?

There is still no consensus on the drugs commonly used for arrhythmia. The main classes used clinically are as follows: The first class is sodium channel blockers, which include three subclasses: moderate, mild, and significant sodium channel blockers, respectively comprising quinidine, lidocaine, and propafenone. The second class mainly consists of adrenergic receptor blockers, with propranolol being a representative drug. The third class of drugs selectively prolongs the repolarization process, among which amiodarone is commonly used clinically. The fourth class is calcium channel blockers, which mainly block calcium channels and inhibit the inflow of calcium, with verapamil being the main representative drug. Long-term use of anti-arrhythmia drugs can cause varying degrees of side effects, with severe cases possibly leading to ventricular arrhythmia or fatal cardiac conduction block. Therefore, when using these drugs clinically, it is essential to strictly control the indications, monitor adverse reactions, and strictly follow the doctor's prescription for rational medication.

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Written by Wang Li Bing
Intensive Care Medicine Department
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What tests are done for arrhythmia?

Arrhythmia is also relatively common in clinical practice, and its common detection method is mainly the electrocardiogram (ECG). ECG is a simple and non-invasive operation that helps to identify the type of arrhythmia. Another method is the 24-hour Holter monitor, which can record all heart rate changes occurring within 24 hours. If an arrhythmia occurs, it is crucial to seek medical attention promptly, visiting a cardiology department. Treatment may involve antiarrhythmic medications, and if possible, a complete electrophysiological examination can be performed.

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Written by Chen Ya
Geriatrics
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Can arrhythmia cause sudden death?

The clinical manifestations of hemodynamic changes caused by arrhythmias mainly depend on the nature, type, cardiac function, and the extent of impact on hemodynamics. Mild conditions such as slight sinus bradycardia, sinus arrhythmia, occasional atrial premature contractions, and first-degree atrioventricular block have minimal impact on hemodynamics and therefore do not exhibit significant clinical manifestations, and sudden death is generally not expected. However, more severe arrhythmias, such as sick sinus syndrome, rapid atrial fibrillation, paroxysmal supraventricular tachycardia, and sustained ventricular tachycardia, can lead to palpitations, chest tightness, dizziness, hypotension, and sweating. In severe cases, syncope, Adams-Stokes syndrome, or even sudden death may occur.

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Written by Wei Shi Liang
Intensive Care Unit
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Can arrhythmia be cured?

Arrhythmias come in many types, most of which are curable. Once arrhythmia occurs clinically, an electrocardiogram should be performed as soon as possible to determine the type of arrhythmia. Common arrhythmias can be classified into tachyarrhythmias and bradyarrhythmias, and based on the location of occurrence, into supraventricular arrhythmias and ventricular arrhythmias. Clinically common are supraventricular arrhythmias, such as sinus tachycardia, junctional tachycardia, along with atrial tachycardia, atrial fibrillation, and atrial flutter. These generally do not affect the stability of hemodynamics and are relatively easy to treat. On the other hand, ventricular arrhythmias such as ventricular fibrillation, ventricular tachycardia, and sinus arrest are clinically challenging to cure and require aggressive resuscitation.