Diagnostics


Diagnostics

The Bristol Heart Rhythm Centre offers a full clinical assessment by a Consultant Cardiac Electrophysiologist - a Cardiologist with a speciality interest in heart rhythm problems, supported by a comprehensive range of diagnostic tests in state of the art facilities. Available investigations include:

  • 12 lead ECGs (electrocardiogram)
  • Holter monitoring
  • Echocardiography
  • Cardiac CT scanning
  • Cardiac MRI scanning
  • Ajmaline testing
  • Exercise testing
  • Reveal device implantation
  • Cardiac electrophysiological studies.

The diagnosis of heart rhythm disorders

There are two key areas that are assessed during a consultation at the Bristol Heart Rhythm Centre.

1. The nature of the arrhythmia itself must be ascertained.

2. The context in which the arrhythmia has arisen must be considered.

An ECG of the patient during an episode of arrhythmia plays a vital role in allowing diagnosis of the arrhythmia. Often patients are in the abnormal rhythm at the time of their consultation. Alternatively, a previous episode of arrhythmia will have been ‘captured’ on an ECG performed in an A+E department or GP practice. We encourage patients to bring any such ECGs that they may possess to their consultation. It remains common however that the arrhythmia may prove elusive and patients are often referred to us for our assistance in documenting the cause of their symptoms. We therefore have a range of diagnostic tools available that we use to ‘capture’ an episode. Portable heart rhythm monitors may be taken home by patients allowing any sporadic episodes to be recorded. Alternatively abnormal rhythms may be induced with exercise testing in clinic or in the cardiac catheter lab at the time of an electrophysiological study. Finally, small heart rhythm monitors can be implanted under the skin to record infrequent rhythm problems that occur during a two year period.

Once an ECG of the abnormal rhythm has been recorded, it is important to then consider the context in which that arrhythmia has occurred, e.g are other medical conditions (especially cardiac conditions) contributing to the arrhythmia. Many arrhythmias occur in otherwise healthy people who have hearts that are structurally normal ie they have a problem relating entirely to the electrical system of the heart. However in other cases a structural problem may contribute to the arrhythmia or impact upon the treatment recommended. It is therefore routine to image the heart using either cardiac echocardiography or cardiac magnetic resonance imaging (CMR) - available on site.

Cardiac Magnetic Resonance Imaging

Cardiac MRI scanning (CMR) and echocardiography represent two technologies that the Bristol Heart Rhythm Centre use to examine the structure of the heart, in particular looking for any weakness of the heart muscle or problems with the heart valves.