| Investigations & potential roles |
|---|
| Chest radiography |
| Exclude concomitant lung disease, heart failure, baseline in patients receiving amiodarone. |
| Ambulatory electrocardiography (Holter monitor, event monitor, loop monitor) |
| Document AF, exclude alternative diagnosis (atrial tachycardia, atrial flutter, AVNRT/AVRT, ventricular tachycardia), symptom–rhythm correlation, assess ventricular rate control. |
| Treadmill exercise test |
| Investigation of patients with symptoms of coronary artery disease, assessment of rate control. |
| Transesophageal echocardiography |
| Rule out left atrial appendage thrombus, facilitate cardioversion in patients not receiving oral anticoagulation, more precise characterization of structural heart disease (mitral valve disease, atrial septal defects, cortriatriatum, etc). |
| Electrophysiological study |
| Patients with documented regular supraventricular tachycardia (ie, atrial tachycardia, AVNRT/AVRT, atrial flutter) that is amenable to catheter ablation. |
| Serum calcium and magnesium |
| In cases of suspected deficiency (ie, diuretic use, gastrointestinal losses), which could influence therapy (ie, sotalol.) |
| Sleep study (ambulatory oximetry or polysomnography) |
| In patients with symptoms of obstructive sleep apnea or in select patients with advanced symptomatic heart failure. |
| Ambulatory blood pressure monitoring |
| In cases of borderline hypertension. |
| Genetic testing |
| In rare cases of apparent familial AF (particularly with onset at a young age) with additional features of conduction disease, Brugada syndrome, or cardiomyopathy. |
AVNRT/AVRT, atrioventricular nodal reentrant tachycardia/atrioventricular reentrant tachycardia.