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What would be the next step after an EKG in determining the cause of my heart fluttering?

Have had what seems like fluttering of heart. Dr did EKG and nothing irregular. Wants me to get an echo. Good advice or not? And will this suffice if all is normal with echo? Age is 63. I've had no chest pain. I realize this can come from many things. Am I on the right track so far? What would be the next step if echo not normal, just to be on the safe side? I'm seeing a regular MD. Thanks.

submitted by Monty from Denton, North Carolina on 2/25/2013


by Texas Heart Institute cardiologist, Scott R. Sherron, MD  

Scott R. Sherron, MDMonty, A sensation of "fluttering" or palpitations can come from many causes, mostly related to electrical issues with the heart. These symptoms can range from very benign PVCs or PACs (premature ventricular or atrial contractions) to atrial fibrillation which is more serious, and many things in between.  If fluttering was not present during  the ECG, then it alone does not adequately evaluate the symptoms. An echo is very useful, since most arrhythmias are much more benign in the presence of normal LV function. However, it would also be worthwhile to be placed on a monitor that would allow the heart rhythm to be recorded during symptoms. If they occur daily, then a 24-hour Holter monitor is appropriate. If the symptoms are less frequent, a monitor that can be worn longer may be the better choice. Some monitors are small and unobtrusive and therefore can be worn fairly easily for up to a month. Most of these tests can be ordered by an internist or family practitioner, but it would be reasonable to see a cardiologist in this scenario as well.  

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Updated February 2013
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