Tachycardia: EKG to determine the cause of palpitations

An electrocardiogram (EKG, ECG) can be very helpful in determining the cause of palpitations and may reveal tachycardia if it is happening at the time the test is given. Since tachycardia may come and go, the EKG more commonly provides clues about the cause of the palpitations by demonstrating evidence of underlying heart disease, such as:

  • Signs of an old heart attack, which may be associated with an arrhythmia that originates in the lower heart chambers (ventricles) as the cause of palpitations.
  • Evidence of a bypass tract, which is an improper electrical connection in the heart.

Why might I need other tests?

If the EKG performed in the office does not reveal conclusive evidence of the arrhythmia, you may require further testing to determine the cause of your palpitations if your doctor suspects an arrhythmia based on your medical history and your physical exam. For example, you may have another heart condition that can cause an arrhythmia or you may have a family member who has had an arrhythmia.

How do monitoring devices help identify an arrhythmia as the cause of palpitations?

Various monitoring devices are available to record the electrical activity of your heart that can show evidence of an arrhythmia when it occurs. The hope is that the monitor will record an arrhythmia if one occurs while you are wearing a monitor. Your heart rhythm is recorded and can be matched to the timing of your symptoms. If an arrhythmia occurs at the time of the symptoms, your doctor may be able to identify the cause of the palpitations. On the other hand, if you have a normal heart rhythm during the palpitations, then it is very unlikely that an arrhythmia is the cause. If the palpitations occur frequently, they may be "captured" on a 24-hour Holter monitor. If they occur less frequently, a more prolonged event monitor is preferred because you can trigger the monitor to record when you feel the palpitations.

Last Updated: September 17, 2008

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