Exams and Tests

The evaluation may include the following tests:

Electrocardiogram(ECG): This is the primary test to determine when an arrhythmia is atrial fibrillation. The test can also sometimes reveal damage to the heart, if there is any.

Lab tests: There is no lab test that can confirm that you have atrial fibrillation. Tests are done to check for certain underlying causes of atrial fibrillation and to rule out heart damage, as from a heart attack. If you are already taking medication for atrial fibrillation, a drug level may be checked to make sure there is enough of the drug in your system to work.

• Complete blood cell count
  
  
• Markers for heart injury (enzymes such as troponins and creatine kinase [CK])
  
  
• Digoxin drug level (in patients taking this medication)
  
  
• Prothrombin time (PT) and international normalized ratio (INR): If you are taking warfarin (Coumadin) to prevent blood clotting, these tests show how well the drug is working to lower your risk of a blood clot.
  
  
• Serum electrolytes to evaluate sodium and potassium levels
  
  
• Thyroid function tests for hyperthyroidism

Chest x-ray: This imagery is used to evaluate for complications such as fluid in the lungs or to estimate heart size

Echocardiogram or transesophageal echocardiogram: This is an ultrasound test that uses sound waves to make a picture of the inside of the heart while it is beating.

• This test is done to identify problems in heart valves or ventricular function or to look for blood clots in the atria.
  
  
• This very safe test uses the same technique used to check a fetus in pregnancy.

Ambulatory electrocardiogram (ECG): This test involves wearing a monitor for a period of time (usually 24-48 hours) to try to document the arrhythmia while you go about your everyday activities.

• The device you wear for 24 to 48 hours is called a Holter monitor.
  
  
• An Event monitor is a device that can be worn for 1-2 weeks and records the heart rhythm when it is activated by the patient.
  
  
• These tests may be used if your symptoms come and go and your ECGs do not reveal the arrhythmia.

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