Palpitations can refer to a whole gamut of heart arrhythmias. It can also be psychogenic. However, like a burglar that comes to rob your house, the type of heart arrhythmias causing palpitations can only determine once it is caught in person.
The first step is to perform an electrocardiogram (ECG). This will give us an idea of any propensity to develop abnormal heart rhythms like the presence of a long QT interval or short PR interval. Occassionally, if we are lucky, it can capture the exact moment of the palpitations and give us an answer.
The next step would be to do an echocardiogram to rule out any structural heart problems which may result in abnormal heart rhythms or arrhythmias. Subsequently to catch the palpitations, our center has a variety of devices which is tailored to the different needs:
- Trans-telephonic monitoring for palpitations which occur once in a few months. This device is usually a single ECG lead recorder that the patient brings home and uses it to record the ECG during the episode of palpitations. The recordings are then transmitted by the patient via a phone call to a cloud based software.
- 24 hour Holter monitoring is for palpitations which occur every day. This device is hooked up to the patient’s chest for 24 hours and continuously records the ECG;
- Spyder ECG monitoring is a more sophisticated version of the 24 hour Holter. It is also attached to the patient’s chest without any wires and records 2 ECG leads which is then transmitted by wireless technology to a cloud based monitoring software. This is monitored by our centre’s staff on a 24 hour basis. This tyope of device is good for palpitations which occur once a week or less frequently.
- Implantable loop recorder is a small lighter sized device that is implanted into the body by a minor surgery and can record ECG for up to 2 years. If there is any abnormal heart rhythm detected, it will alert us via wireless technology. This device is usually the last resort when the palpitations are very infrequent and difficult to capture.