Diagnosing Ventricular Arrhythmias

Doctors at NYU Langone’s Heart Rhythm Center are experts in the diagnosis of all types of ventricular arrhythmias, potentially life-threatening heart rhythm disorders that originate in the heart’s lower chambers, or ventricles.

To diagnose ventricular arrhythmia, our heart specialists first perform a physical exam. They check your blood pressure and listen to your heart with a stethoscope for a murmur—an unusual swishing sound sometimes heard during a heartbeat—which can be caused by a heart problem.

Your doctor asks about your family history. Some arrhythmias are inherited. The risk of heart disease, which can trigger arrhythmia, increases when a family member has a heart condition. Please tell your doctor about any medical conditions you have. Conditions such as diabetes, sarcoidosis, and hyperthyroidism can increase your arrhythmia risk. Your doctor also asks about your lifestyle, including your exercise habits and use of recreational drugs.

Your doctor may order the following tests to help diagnose a ventricular arrhythmia.

Electrocardiogram and Stress Test

An electrocardiogram, or EKG, is a noninvasive test that measures the electrical impulses of your heart through small electrodes attached to your chest, wrist, and ankles. The electrodes transmit information about your heart rhythm to a computer monitor. A stress test is an EKG that is performed while you are walking on a treadmill and naturally increasing your heart rate.

Because each type of arrhythmia produces unique EKG results, this test is essential for correctly identifying the type of arrhythmia. Our electrophysiologists are highly skilled in interpreting EKG results to pinpoint an exact diagnosis.

Imaging Tests

Ultrasound uses sound waves to create images of the heart. A technician presses a device called a transducer against your chest to send images of the heart to a computer. This test can help identify whether your heart is pumping blood.

Your doctor may also request an MRI, which uses radiofrequency to create detailed images of the heart, or an angiogram, which uses X-ray scans to create an image of your arteries.

Surveillance Monitoring

If your arrhythmia occurs sporadically, your doctor may recommend surveillance monitoring using a Holter monitor or ambulatory telemetry device that records your heart rhythm for 24 hours or up to 2 weeks. Your doctor uses that data to determine how best to manage your symptoms.

Holter Device

A Holter device records your heart rhythm for 24 to 48 hours. About the size of a smartphone, you wear it on a strap that’s placed around your neck or attached to your belt or pants. The device is connected to sticky electrodes on your chest. During the test, you are asked to write down any symptoms, such as heart palpitations or lightheadedness, you may be experiencing.

Ambulatory Telemetry Device

An ambulatory telemetry device is a lightweight, portable heart monitor that measures and records your heart rhythm for up to two weeks through electrodes attached to your chest. When you experience a symptom of arrhythmia, such as lightheadedness or palpitations, you press a button on the device, which records the data. Some devices automatically record changes in heart rhythms. Data collected are sent to your doctor through a secure website.

Genetic Testing

Because some ventricular arrhythmias are caused by genetic heart rhythm disorders, your NYU Langone doctor may recommend genetic testing through our Inherited Arrhythmia Program. This may include blood and stress testing, as well as advanced imaging. If you receive a genetic heart rhythm disorder diagnosis, your doctor may suggest that family members be tested as well.