The continuous-loop event recorders are also worn by the exam taker and continuously record data, but the data is saved only when someone manually activates the monitor. The continuous-loop recorders can be long worn for longer periods of time than the Holter monitors and therefore have been proven to be more cost-effective and efficacious than Holter monitors. Also, because the person triggers the device when he/she feel the symptoms, they are more likely to record data during palpitations. An implantable loop recorder is a device that is placed subcutaneously and continuously monitors for cardiac arrhythmias. These are most often used in those with unexplained syncope and can be used for longer periods of time than the continuous loop event recorders. An implantable loop recorder is a device that is placed subcutaneously and continuously monitors for the detection of cardiac arrhythmias. These are most often used in those with unexplained syncope and are a used for longer periods of time than the continuous loop event recorders. Electrophysiology testing enables a detailed analysis of the underlying mechanism of the cardiac arrhythmia as well as the site of origin. EPS studies are usually indicated in those with a high pretest likelihood of a serious arrhythmia. The level of evidence for evaluation techniques is based upon consensus expert opinion. Treatment
Treating palpitation will depend on the severity and cause of the condition. Radiofrequency ablation can cure most types of supraventricular and many types of ventricular tachycardias.
An implantable loop recorder may be helpful in people with very infrequent but disabling symptoms. This recorder is implanted under the skin on the front of the chest, like a pacemaker. It can be programmed and the data examined using an external device that communicates with it by means of a radio signal.Investigation of heart structure can also be important. The heart in most people with palpitation is completely normal in its physical structure, but occasionally abnormalities such as valve problems may be present. Usually, but not always, the cardiologist will be able to detect a murmur in such cases, and an ultrasound scan of the heart (echocardiogram) will often be performed to document the hearts structure. This is a painless test performed using sound waves and is virtually identical to the scanning done in pregnancy to look at the fetus. Evaluation
A 12-lead electrocardiogram must be performed on every patient complaining of palpitations. The presence of a short PR interval and a delta wave (Wolff-Parkinson-White syndrome) is an indication of the existence of ventricular pre-excitation. Significant left ventricular hypertrophy with deep septal Q waves in I, L, and V4 through V6 may indicate hypertrophic obstructive cardiomyopathy. The presence of Q waves may indicate a prior myocardial infarction as the etiology of the palpitations, and a prolonged QT interval may indicate the presence of the long QT syndrome.Laboratory studies should be limited initially. Complete blood count can assess for anemia and infection. Serum urea, creatinine and electrolytes to assess for electrolyte imbalances and renal dysfunction.