Palpitations and Arrhythmia Evaluation

What Is It?

Awareness of abnormal or forceful heartbeats. Usually benign (PVCs, sinus tachycardia) but can represent serious arrhythmia (AFib, SVT, VT). Red flags: syncope, chest pain, dyspnea, structural heart disease.

How Is It Diagnosed?

EKG during symptoms (if possible). Holter monitor (24-48 hours) or event recorder (30 days) for intermittent symptoms. Echocardiogram if structural heart disease suspected.

How Is It Treated?

PVCs/benign: reassurance, reduce caffeine and stimulants, treat anxiety. SVT: vagal maneuvers, adenosine, beta-blockers, catheter ablation. AFib: rate or rhythm control, anticoagulation. VT: urgent cardiology.

Tests and Imaging Typically Needed

EKG, Holter monitor, event recorder, echocardiogram, TSH, BMP, CBC, electrolytes, caffeine/stimulant history.

Approximate Self-Pay Costs

Office visit: $95-$150. EKG: $30-$60. Holter monitor: $150-$300. Event recorder: $300-$600. Echocardiogram: $500-$900.

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