How are Heart Arrhythmias Diagnosed?


To diagnose a heart arrhythmia, a doctor will first ask questions about your symptoms and medical history and perform a physical examination. Then, diagnostic tests can be conducted to confirm the presence of an arrhythmia and detect any conditions that could be causing it. Diagnostic tests include:

  • Electrocardiogram, also known as an EKG or ECG. This test provides an easy, painless way for a doctor to check a patient's heart activity. Electrode sensors are placed on the chest and sometimes the arms and legs. The electrodes detect and record information about heart activity and electrical impulses in the heart for diagnosis of arrhythmias.
  • Holter monitor. A patient wears a portable EKG device that records heart rhythm and rate throughout the day. A doctor then downloads and analyzes the results.
  • Event recorder is a device with electrodes that can be worn for about a month. The patient presses a button when irregular heart rhythm symptoms arise, causing the device to record heart activity. The doctor analyzes the recordings after the testing period. This can be useful if symptoms are experienced sporadically.
  • MCOT (Mobile Cardiac Outpatient Telemetry) monitors can gather heart activity data for up to a month via Bluetooth technology. A doctor can then analyze the results to confirm a diagnosis. Consumer devices such as Apple Watches also have applications that can record heart rates continuously, providing data that a doctor can analyze.
  • Echocardiogram. A doctor uses a wand-like instrument that emits ultrasound waves to produce computerized images of the heart in motion. This enables the doctor to detect structural or blood flow issues within the heart and determine if heart muscle or value issues are causing the arrhythmia.
  • Implantable loop recorder involves implanting a small event recorder under the skin in the chest area. It constantly records the heart's activity and detects irregular rhythms, it is also useful if symptoms are experienced infrequently.
  • Stress tests. An EKG will be conducted while the patient walks on a treadmill or rides a stationary bike to monitor the heart during exercise. The intensity of the exercise will increase as the test continues to determine the stress level that causes the arrhythmia.
  • Tilt table test is useful if a patient has been experiencing fainting spells. The patient lies flat on a table tilted at different angles while an EKG is performed to monitor blood pressure and heart rhythm. This can help doctors determine if fainting spells are caused by issues in the interaction between the brain, heart, and blood vessels.
  • Electrophysiology testing and mapping. A special catheter is inserted into the heart to detect and record electrical activity. The doctor uses electrodes on the catheter to stimulate the heart and safely cause (and stop) an arrhythmia. This enables doctors to determine the location of the arrhythmia and the best treatment options.

How are Heart Arrhythmias Treated?


There are several options available for the treatment of heart arrhythmias. These can range from drug treatments to nonsurgical, implant, or surgical treatments. Some of these arrhythmia treatments may be recommended in combination with one another.

Many people are able to have their heart rhythm controlled using medication. Examples of antiarrhythmic drugs include:

  • Amiodarone (Cordarone, Pacerone). This drug is used to treat many different arrhythmias. It works by modifying the electrical signals in the heart. Patients may be monitored during use to assess the effectiveness of the drug and the appropriateness of the dose.
  • Tikosyn (Dofetilide), which modifies certain electrical signals in the heart. Patients are usually monitored for at least three days when starting use or modifying the dosage.
  • Multaq (Dronedarone). This drug is used to treat symptoms of atrial fibrillation. It can be prescribed on its own or with other medications.
  • Flecainide (Tambocor). Flecainide works by slowing the signals in the heart in order to regulate and stabilize the rhythm of an individual's heart.
  • Procainamide (Procan, Procanbid) works to combat arrhythmias by slowing certain signals and reducing the sensitivity of the heart's tissues, which then makes the heart more resistant to irregular rhythms. Procainamide is only available intravenously in the US.
  • Sotalol (Betapace) is a beta blocker and potassium channel blocker. This can help the heart beat more slowly and regularly.

Catheter ablation

Our doctors at NewYork-Presbyterian are experienced in curing arrhythmias by disrupting the electrical impulses that cause them. This technique is called catheter ablation. This is a nonsurgical percutaneous approach that can often treat supraventricular arrhythmias (including atrial fibrillation ) and ventricular arrhythmias.

  • These are very effective procedures with high success rates depending on the arrhythmia, and a low risk of complications. NewYork-Presbyterian discharges most patients in less than 24 hours following this procedure.
  • During catheter ablation , electrode catheters are guided through your veins to various positions in the heart where radiofrequency energy or freezing temperatures (cryoablation ) are applied. We are also offering new advanced forms of energy to treat arrhythmias. This new form of energy interrupts the electrical impulses causing your arrhythmia.
  • Our electrophysiologists (or heart rhythm specialists) combine information gained from previous CT or MRI scans taken before your procedure with advanced mapping systems to help guide the procedure to maximize effectiveness and minimize complications.

Implanted devices

Some arrhythmias are treated with medication or ablation, but others are treated with surgically implanted devices that correct abnormalities in your heart's rhythm. We also have specialized expertise in the removal of leads in individuals with damaged or infected devices. You may benefit from one of the technologies below.


If your heartbeat is too slow, you may benefit from a permanent pacemaker. This is a small device implanted near your chest under the skin. The device has leads going into your heart, usually through a venous system, that keeps your heart beating at a normal rate. These can be used alone or in combination with other devices to treat arrhythmias. We can also place pacemakers without leads that are directly implanted in the heart without a generator under the skin or leads. 

Implantable cardioverter defibrillators (ICDs)

ICDs can be implanted under the skin in the chest, of patients who have or are at risk of arrhythmias. ICDs can be entirely subcutaneous (without leads in the heart) or transvenous  (with leads traveling into the heart). They protect against life-threatening fast heartbeat irregularities and sudden cardiac death. These devices monitor your heartbeat and can sense potentially dangerous abnormalities in your heart rhythm. The ICD can deliver electrical impulses to stop the arrhythmia and allow your normal heartbeat to continue.

Biventricular pacemakers

These implantable devices have a pacemaker wire that directly paces the beating of the left ventricle and a standard pacemaker wire in the right ventricle. They are designed to resynchronize the beating of the heart in people with congestive heart failure whose heart contractions have fallen out of sync. They are often combined with ICDs for people at risk of life-threatening arrhythmias.

LAAO devices

Left Atrial Appendage Occlusion (LAAO) devices can be implanted in the heart using a catheter. These mechanical devices are intended to help prevent stroke in patients with non-valvular atrial fibrillation. 

Surgical treatments

Our heart surgeons offer surgical procedures for people with atrial fibrillation that cannot be adequately controlled with medications, ablation, or implanted devices.

Maze procedure

This open-heart procedure interrupts the electrical impulses that cause abnormal heart rhythm. The surgeon will make incisions in both atria, which heal into scar tissue. This acts as a roadblock that prevents abnormal electrical impulses from passing through the heart. The Maze procedure is commonly performed with mitral valve repair, replacement, and coronary artery bypass graft. 

Surgery for Ventricular Tachycardia 

Surgery can be performed for some patients to remove scar tissue from under the heart's lining to treat ventricular tachycardia. 

Robotic heart surgery

This is a minimally invasive, robotically assisted version of surgical atrial fibrillation ablation. This can be done without stopping your heart or using a heart-lung machine.  




Although most arrhythmias are not life-threatening, some cases may point to a serious heart condition that should be addressed and treated immediately. Consult a doctor immediately if your arrhythmias are causing chest pain, shortness of breath, dizziness, lightheadedness, or fainting.

An arrhythmia is a condition caused by disruptions or irregularities in the electrical signals in the heart. Heart palpitations  are a symptom felt by a person. They can be related to arrhythmia but are often experienced by people during times of stress or when external factors trigger them. Both arrhythmias and palpitations may indicate a more serious underlying heart condition, so consult a doctor if you are experiencing symptoms.

Many arrhythmias are not life-threatening and may not require any serious treatment at all. People with heart arrhythmias can lead normal, productive lives. However, in some cases, arrhythmias may be quite serious and even life-threatening, so it is important to consult with a doctor to diagnose the severity of the condition and begin treatment if necessary.

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Trust NewYork-Presbyterian for Heart Arrhythmia Treatment

Healthcare experts at NewYork-Presbyterian are experienced in treating heart arrhythmias and deeply understand the symptoms experienced by those suffering from this condition. Schedule an appointment to learn more about available treatment methods and begin your recovery journey.