The Holter is a small, wearable device that tracks your heart rhythm. This records the heart’s electrical activity using electrode patches placed on a person’s chest. The patches are attached by wire to a portable monitor about the size of a small tape recorder. It is usually worn for one or two days. The recorded cardiac electrical activity by the Holter is then transferred to a computer and the rhythm is analyzed by the doctor.
HEAD-UP TILT TEST (HUTT)
Your doctor might recommend a tilt table test if you have repeated unexplained episodes of lightheadedness, dizziness, or fainting. You will lie on a table that tilts by varying angles recreating the conditions that cause fainting. While on the table you will be connected to a machine that measures how your blood pressure, heart rate, and heart rhythm responds to changes in your body position. This procedure takes about two hours.
EXTERNAL LOOP RECORDER
An external Loop Recorder can be continuously worn for several days up to a month. Like the Holter, this device also records electrical activity using electrode patches placed on your chest which are attached by wires to a portable monitor. This gadget is used in patients who have symptoms that occur once or twice in a week to once a month.
FLECAINIDE PROVOCATION TEST
If Your close family member had a sudden cardiac death or if you were resuscitated from a sudden cardiac arrest but your ECG seems normal, your doctor will suspect that you have Brugada syndrome. Here a structurally normal heart can develop a fast heart rhythm due to changes within the ion channels of the heart. Flecainide is a drug that blocks the faulty sodium channels and unmasks the ECG changes. You will be given the drug through a vein in your arm and the ECG will record how your heart reacts to the flecainide giving us information about the cause of your potential arrhythmia.
The treadmill test helps your doctor understand how the heart handles physical activity (stress). You will be asked to walk on a treadmill, first slowly and then with gradually increasing speed and inclination. You may be advised a stress test if you have signs or symptoms of coronary artery disease or exercise-induced abnormal heart rhythm. We have 3 treadmill machines and these tests are performed daily when indicated.
Some patients have their windpipe blocked when sleeping causing a condition called sleep apnoea. It is common in those who are overweight, have hypertension, and are above 40 with a noticeable snore. Sleep apnea leads to the brain and the heart getting less oxygen which can result in abnormal heart rhythms like atrial fibrillation. A sleep study is done by monitoring the oxygen level in the blood while a patient is asleep. Patients are advised to lose weight and sleep on their side to reduce sleep apnea. If it is severe, they are advised to use a special breathing machine called a CPAP.