Atrial fibrillation other imaging findings

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Sinus rhythm

Atrial fibrillation

Atrial Fibrillation Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Other diagnostic studies include the holter monitor to assess symptomatic episodes of atrial fibrillation over a 24 hour period, and exercise stress testing to assess a how a patient's heart rate responds to exertion. The main benefits to performing an exercise stress test are to reproduce exercise induced atrial fibrillation, and to exclude ischemia before initiating treatment with type 1C antiarrhythmic medications.

Other Imaging Studies

Ambulatory Holter Monitoring

Main article: Holter monitor

A holter monitor is a wearable ambulatory heart monitor that continuously monitors the heart rate and heart rhythm for a short duration, typically 24 hours. In individuals with symptoms of significant shortness of breath with exertion or palpitations on a regular basis, a holter monitor may be of benefit to determine if rapid heart rates (or unusually slow heart rates) during atrial fibrillation are the cause of the symptoms.

Exercise Stress Testing

Main article: Cardiac stress test

Some individuals with atrial fibrillation do well with normal activity but develop shortness of breath with exertion. It may be unclear if the shortness of breath is due to a blunted heart rate response to exertion due to excessive AV node blocking agents, a very rapid heart rate during exertion, or due to other underlying conditions such as chronic lung disease or coronary ischemia. An exercise stress test will evaluate the individual's heart rate response to exertion and determine if the AV node blocking agents are contributing to the symptoms. As a summary the main benefits of performing an exercise stress testing:

• If the adequacy of rate control is in question (permanent AF).
• To reproduce exercise induced AF.
• To exclude ischemia before treatment of selected patients with a type IC antiarrhythmic drug.