Evidence Checklist: Cardiac Arrhythmia

ECG and/or Holter monitor documenting arrhythmia type and frequencyCritical

Electrocardiogram or 24-48 hour Holter monitor recording confirming the arrhythmia diagnosis, rhythm type, and episode frequency. This is the primary objective evidence.

Echocardiogram with ejection fractionCritical

Echocardiography documenting structural heart disease, ejection fraction, and chamber size — all relevant to rating severity.

Exercise stress test with METs estimationCritical

Stress test documenting functional exercise capacity in METs. METs level drives the rating percentage under the General Rating Formula for heart conditions.

Nexus opinion linking arrhythmia to service ("at least as likely as not")Critical

A medical opinion connecting the arrhythmia to service-related causes such as stimulant use during service, service-connected hypertension, CAD, or other cardiac conditions.

Electrophysiology (EP) study results (if performed)

EP study documenting inducible arrhythmias, ablation procedures, or conduction system abnormalities.

Treatment records including antiarrhythmic medications and procedures

Records of antiarrhythmic drug therapy (amiodarone, flecainide, beta-blockers), cardioversion, or ablation procedures.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

Completed DBQ Heart ConditionsCritical

Standardized form capturing arrhythmia type, ECG/Holter findings, METs, ejection fraction, and functional limitations.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.