Obligatory medical device diagnostics.
- Electrocardiogram (ECG; recording of the electrical activity of the heart muscle).
- [Sinus bradycardia: regular rhythm and inconspicuous P waves that are transitioned one-to-one.
- Sinus arrest: completely absent atrial actions.
- Atrial fibrillation (VHF):
- Variable picture with more or less delineable atrial actions, often flicker waves expressing completely uncoordinated atrial excitation (no P waves)
- Absolute arrhythmia of the heart due to an irregular conduction (irregular RR intervals).
- QRS complexes narrow and normal shape.
- Atrial flutter:
- Strictly regular atrial actions: regular, sawtooth P waves with a frequency of 250-400/min.
- Narrow QRS complexes
- AV nodal block and conduction in a 4:1 or 2:1 ratio, rarely alternating.
- Atrial flutter with regular AV conduction (usually 2:1): narrow ventricular complex (QRS width ≤ 120 ms).
- Ectopic atrial rhythms: mostly tachycardic rhythms; typically recognizable by the often atypical P-wave morphologies with e.g. superior axis, i.e. negative in II, III, aVF.
- Retrograde atrial excitation: P-wave with superior axis, i.e., propagation from AV node across atrium, e.g., in the context of junctional rhythms]
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification.
- Exercise ECG (electrocardiogram during exercise, that is, under physical activity/exercise ergometry) – detection of exercise-induced cardiac arrhythmias and abnormalities of heart rate increase, e.g., in sick sinus syndrome.
- Long-term ECG (ECG applied over 24 hours) – for more accurate assessment of cardiac function within the day.
- Echocardiography (echo; heart ultrasound).
- Event recorder (external or implantable).
