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How do Doctors Measure Atrial Fibrillation with an EKG?

By Sarah A. Kleven
Updated Feb 26, 2024
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Atrial fibrillation, or an unsynchronized heart rhythm, can be diagnosed through a medical test known as an electrocardiogram (ECG or EKG). Doctors can diagnose atrial fibrillation with an EKG as a result of the test being administered for other reasons, such as a physical exam done to diagnose another ailment. The administration of an EKG also can be ordered for patients exhibiting symptoms of heart quivering, leading to confirmation of an atrial fibrillation diagnosis.

An electrocardiogram is administered through small patches or stickers called electrodes. These painless electrodes are placed on the patient's arms and legs and across his or her chest. The heart's electrical impulses are recognized by the electrodes and are recorded as waves on a monitor or printed out on paper.

The electrical impulses that the electrodes record show how fast the patient's heart is beating, how strong the heart is beating and whether the beat is irregular. Atrial fibrillation with an EKG is recorded within only records a few seconds of the heart's rhythm. This means that an unsynchronized heart rhythm might not be recorded. If this might be the case, a doctor might have the patient use a portable EKG test to monitor the heart for a longer period of time.

There are two types of portable tests that can be used to measure atrial fibrillation with an EKG: Holter monitors and event monitors. Holter monitors use the same type of electrode patches or stickers or monitor the heart's activity. Rather than capturing several seconds of the heart's rhythm, however, a Holter monitor is worn for 24-48 hours.

The electrodes are attached to a small, portable monitor that can be clipped to a patient's pocket or worn around the neck on a necklace. The patient goes about his or her normal daily activities but also keeps a diary of those activities and any atrial fibrillation symptoms. After the monitoring period, the information that was captured is analyzed along with the diary of symptoms and activities.

An event monitor is similar in style to a Holter monitor. A patient wears the monitor, which is hooked to electrode patches. An event monitor, however, records only some of the heart's activity. A patient can activate an event monitor by pushing a button when he or she feels atrial fibrillation symptoms, or some event monitors begin recording symptoms themselves when they sense an unsynchronized heart rhythm. Event monitors can be worn for months, or as long it takes to record the heart symptoms necessary to measure atrial fibrillation with an EKG of this type.

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