ECG

Blood glucose

Plasma sodium, potassium, calcium and magnesium

Plasma creatinine

Plasma TSH

Plasma troponin if acute coronary syndrome suspected

Plasma BNP or NT-pro-BNP if heart failure suspected

Urine drug screen if illicit drug use considered

Chest X-ray

Echocardiogram if there is clinical evidence of an underlying structural abnormality or there is a proven sustained or non-sustained arrhythmia

ECG monitoring:

• 24-hour ECG if frequent ventricular extrasystoles seen on 12-lead ECG, or if palpitation occurs at least daily
• 7-day ECG monitoring if palpitation occurs approximately weekly
• ECG event recorder (smartphone-based systems now available)
• Implantable ECG loop recorder (for selected high-risk patients)

Electrophysiological study, in selected patients with cardiology advice