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If a patient experiences any sensation of irregular pulse rhythm the single best advice
I can give them is to obtain an EKG. An EKG during the arrhythmia, or the symptoms, is
the gold standard to document exactly what this is. This is not always feasible if the
symptoms are fleeting, lasting only seconds to minutes. But in the event of longer standing
palpitations an EKG where they simply place electrodes on the chest, takes less than two
minutes, would be the definitive diagnosis for atrial fibrillation. The critical step
is to make the diagnosis earlier rather than later such that potentially important decisions
can be made to avoid downstream complications. When someone has atrial fibrillation there
are a couple very simple tests that usually are needed upon the diagnosis. The first would
be some basic lab work. Classically excess thyroid hormone can cause atrial fibrillation
so it’s important to rule that out with a simple laboratory test. The second test
that’s essential is an ultrasound of the heart, also called an echocardiogram. It’s
similar to when looking at a baby in the belly, except they put a probe on the chest and actually
see the heart squeeze. That allows you to look at the function of the heart and the
valvular performance of the heart. Sometimes valvular problems can actually trigger atrial
fibrillation. So those two things which can be performed in very short order would be
the kind of the bare minimum work up to get the process going with atrial fibrillation.