Palpitations -Tests
I have been to the doctor because I was so worried about these rapid heartbeats that occurred. He has given me a little machine to record any attacks that I get in future. Can you tell me more about this please?
Because palpitations don’t usually occur when you visit the doctor, a 24-hour ECG is often used. This is like a ‘Walkman’ but it records your heartbeats instead of playing music.
The digital card is replayed through a computer and we see the results in a matter of minutes. It does not record any sound so you need not worry that Big Brother is listening in!
You can use this machine at home so that the doctors can watch what your heart is doing during normal daily life. You will be asked to keep a diary and the recording will be checked for times when you felt palpitations or became dizzy.
Four electrodes are attached to your chest and fastened with wires to the recorder which is worn on a belt round your waist. The monitor is quiet and you should not be inconvenienced.
Whilst using the recorder, act normally and try to bring on the symptoms you have been having. You are not allowed to have a bath or shower without a special cover being used. You will be asked to return the recorder the next day so that we can analyse the recording to see if you need any special treatment. Sometimes we do several recordings over 2-5 days.
I think the machine that I am to be given is called an event recorder. Is this different to the ‘Walkman’-type recorder?
This is a small machine which you put on your chest to record a palpitation as it happens. It is about the size of a mobile phone and can be carried easily.
The palpitation is then decoded over the telephone or in the technicians’ department, and printed out on an ECG. It is useful when attacks are infrequent but noticeable, and they have to be long enough for you to take action to record them. You will be shown how to use it by the technician at the outpatient department when you collect it.
There are now several recorders which you can activate yourself some are very small so they are easy to live with. They store information which can then be downloaded and analysed on a computer.
They are particularly useful when attacks are infrequent, and where a 24-hour ECG may miss them. Sometimes a device called a Reveal is inserted under the skin, under local anaesthetic. This is about the size of a PP3 battery and can be used to record infrequent episodes, being kept in place for up to a year.
An appointment has been made for me to go to hospital for electrophysiological (EPS) tests. What are these?
These are tests which have to be done in hospital, not at home. Pacemaker catheters (usually four) are passed via a vein at the top of your leg to the heart and the source of palpitations pinpointed and analysed with complex computers. It usually takes up to an hour but can take several hours; it generally needs to be done with X-ray guidance in the catheter laboratory.
The only pain you should feel is the local anaesthetic in the groin, but as the doctor moves the catheters you may become aware of your palpitations as the doctor identifies them and tries to get them to occur again. It is usually done as a day case, or one night in hospital may be advised.
