Atrial fibrillation, also known as AFib, occurs when abnormal electrical impulses start firing in the atria resulting in a highly irregular pulse rate. Common symptoms include a fluttering heartbeat and fatigue. However, AFib may sometimes not cause symptoms and be diagnosed during a regular physical checkup.

So, if your doctor hears an irregular heartbeat when listening to your heart with a stethoscope, they may ask for other tests to confirm their diagnosis. Here’s how atrial fibrillation is diagnosed:

Physical Exam

As already mentioned, doctors can hear an irregular heartbeat with a stethoscope. Hence, they will listen to your heart to check whether there is something abnormal with your heartbeat’s rate and rhythm. They will also take your pulse and blood pressure. And, they will listen to your lungs as well.

But, to get a diagnosis you will also have to answer questions regarding your health history, family medical history, symptoms you experience, the time you experience symptoms, medications you take, your health habits, etc.

Electrocardiogram (EKG)

This simple and noninvasive test is one of the most helpful in the Afib diagnosis process. A doctor will place electrodes on different areas of your body which will record signals that make wave patterns on the results. An electrocardiogram records the electrical activity of your heart and shows the speed and rhythm of your heartbeat, as well as the strength and timing of the electrical signals.

Holter Monitor

An EKG cannot always catch Afib as it is a quick snapshot of your heart’s electrical activity. That’s why you may need to wear a Holter monitor for 24 to 48 hours. It involves a small device, which you can keep in a pocket or hang around your neck, and electrodes connected with wires. This device will record the electrical activity of your heart for a longer time and thus provide a better chance of catching an abnormal heart rhythm, i.e. an arrhythmia.

Event Monitor

Similar to a Holter monitor, this test is used to record the activity of your heart only at certain times over a 30-day-long period. It starts recording only when it notices something wrong or when you push a button if you experience dizziness, weakness, lightheadedness, or a racing or fluttering heart.

Stress Test

As the name itself suggests, this test puts extra stress on your heart to check how it works when working hard and beating fast. The test itself involves an EKG that will record your heart rate and blood pressure while doing exercise such as riding a stationary bike or walking or running on a treadmill.

Echocardiogram

An echocardiogram uses sound waves and a computer to represent your heart as a moving picture. It can provide your doctor with some meaningful information like the size and shape of your heart, how your heart muscle and valves are working, and where your heart muscle fails to contract on time.

Blood Tests

Although blood tests themselves cannot point to atrial fibrillation, they are commonly used when getting an AFib diagnosis because they may suggest what might be causing your irregular heartbeat. Indeed, blood tests can point to infection, thyroid or kidney issues, heart attack signs, etc.

Electrophysiology Study (EPS)

Finally, an EPS can indicate the problem causing your arrhythmia and help find the best treatment. This test is an invasive one as it is an operation involving a thin, flexible electrode inserted into a blood vessel leading to the heart. The entire procedure may last 1 to 4 hours and requires 4-6 hours of recovery in the hospital.