Stress Test
In addition to non-invasive tools like ECGs, loop recorders, and Holter monitors, and invasive procedures like implantable loop recorders and EP studies, physicians employ other diagnostic methods to evaluate patients with suspected arrhythmias.
A treadmill stress test is a common diagnostic tool used to assess the health of your heart. It's particularly useful for diagnosing coronary artery disease, a condition that can cause chest pain. Electrophysiologists may also use this test to evaluate specific heart rhythm disorders, such as exercise-induced rapid heartbeats or slow heartbeats, and to optimize the settings of pacemakers or defibrillators.
During a treadmill stress test, the patient walks or runs on a treadmill while their heart rate and rhythm are monitored using an ECG. The intensity of the exercise gradually increases. This test can help identify underlying heart conditions, such as coronary artery disease. To provide a more comprehensive assessment, the test is often combined with other imaging techniques like echocardiography.
Echocardiography
An echocardiogram is a safe, non-invasive test that provides real-time images of your heart.
A small device, called a transducer, is placed on your chest to send and receive sound waves. These sound waves create detailed pictures of your heart's structure and function, allowing your doctor to assess:
- Heart valves: Detecting issues like mitral valve prolapse or aortic stenosis.
- Heart chambers: Identifying enlargement or other abnormalities.
- Surrounding tissues: Checking for any problems in the areas near the heart.
This test is risk-free and requires no radiation or dye.
Electrophysiologists rely on echocardiograms to evaluate the heart muscle's health. This non-invasive test measures the heart's pumping efficiency, known as ejection fraction. A low ejection fraction can indicate heart failure and may necessitate a defibrillator. Additionally, echocardiograms can detect specific heart conditions associated with irregular heart rhythms, including:
- Hypertrophic cardiomyopathy: A condition where the heart muscle thickens.
- Epstein anomaly: A rare heart defect affecting the tricuspid valve.
- Arrhythmogenic right ventricular dysplasia: A genetic disorder that weakens the heart muscle.
By identifying these conditions, electrophysiologists can develop appropriate treatment plans to manage arrhythmias and prevent sudden cardiac arrest.
Tissue Doppler
A tissue Doppler test is a specialized echocardiogram that provides detailed information about the left ventricle's muscle motion. This test helps assess the timing and strength of the heart's contractions, which can be impaired in heart failure. By analyzing these parameters, doctors can identify patients with severe heart failure who may benefit from cardiac resynchronization therapy (CRT).
CRT is a specialized pacemaker or defibrillator that delivers synchronized electrical impulses to the heart's ventricles. This coordinated electrical stimulation helps the heart pump more efficiently, improving blood flow and reducing symptoms of heart failure, such as shortness of breath and fatigue.
Stress Echo
A stress echocardiogram is a non-invasive test that combines exercise stress testing with an echocardiogram. During the test, you'll walk on a treadmill while your heart is monitored. An echocardiogram will be performed at rest and again after exercise. By comparing these images, doctors can assess how well your heart functions under stress and identify any areas of reduced blood flow, which may indicate coronary artery disease.