Electrocardiogram or EKG
Electrocardiograms or EKGs are one of the most recognizable tools in the cardiologist’s armamentarium. You have likely seen an EKG at your cardiologist’s office, maybe even at your primary care physician’s office. More likely than not you have been hooked up to said EKG machine and had a diagnostic scan of your heart. For many irregular heart rhythm issues, the EKG is excellent and when it was invented, became a revolutionary tool in the diagnosis and treatment of these disorders.
However, arrhythmias and in particularly atrial fibrillation or Afib are not predictable. Indeed, most cases of Afib begin as occasional or paroxysmal. This means that an EKG, which only offers a snapshot in time of the heart’s rhythm, will likely not be able to detect it. Or if it does, it is through sheer luck. So, for the patients who complain of chest discomfort, their heart feeling like it’s beating out of their chest and more, they may not receive the diagnosis they need with a simple EKG.
With that said, an EKG is always an excellent first line option to seeing if a heart rhythm disorder can be detected. Indeed, some patients may be in continuous Afib and not know it, in which case an EKG is all we need. Ultimately, it is a very easy test to administer, and it has no risk whatsoever.
However, as electrophysiologists, we rely more on the advanced heart rhythm monitoring tools including Holter Monitors, event monitors and loop recorders. These tools can offer longer term data anywhere from three days to three years, which makes it very likely that even the most occasional of arrhythmia episodes is detected.