On occasion, it is necessary to undertake invasive diagnostic tests to assess the heart.

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The first of these is a diagnostic coronary angiogram or cardiac catheterisation.  This test allows the coronary arteries to be imaged and pressure measurements to be made from directly inside the heart.

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An implantable loop recorder is a small cardiac monitor that can be implanted beneath the skin to continuously monitor the heart rhythm.  This can be useful in diagnosing the cause of rare events such as palpitation or blackouts.