Clinical Assessment of the Cardiac Arrhythmia Patient

Arrhythmias cause a wide array of problems and symptoms. They can be associated with increased an risk of death and disability, depending on the type, rate, and frequency and on any associated underlying conditions. The patient with documented or suspected arrhythmias requires careful and complete assessment. Diagnostic considerations and therapeutic interventions can be challenging. Clinical assessment must be individualized but is based upon a large body of scientific literature that considers the relationship between the arrhythmia, underlying comorbidities and processes that trigger, or exacerbate, the arrhythmia and affect outcomes. This introductory article focuses on the clinical assessment of the patient with suspected cardiac arrhythmias and includes information on arrhythmia definition and identification, clinical assessment and correlation with symptoms, an approach to assessment and management, as well as long-term surveillance. Specifics regarding symptoms and diagnostic tools and techniques are discussed. Thus, evaluation of the patient with an arrhythmia involves careful assessment of the symptoms, consideration of underlying cardiovascular and associated comorbidities, correlation of symptoms with the arrhythmia, risk stratification based on clinical diagnosis and arrhythmia type, and decision regarding the need to treat the symptom and reduce the risk for serious adverse outcomes.