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Heart Skipped A Beat? Here’s why it’s not as romantic as it sounds

Even back in the ’60s, almost every love song ever written talked about one’s heart skipping a beat – an ode to how their significant other made their heart flutter. 

However, if you’re not living in a musical and your heart’s been skipping beats often, that may be an arrhythmia.

Arrhythmias are a type of heart disorder that affects the heart’s rhythm. This might mean that your heart beats too fast, too slow, or just irregularly. One of the most common symptoms of arrhythmia is heart palpitations, which can feel like a fluttering in the chest, a pounding or rapidly beating heart, or even the skipping of a heartbeat. While heart palpitations are usually harmless, they can also be a sign of more serious health conditions, especially if they occur frequently.

Maybe it’s the coffee, and maybe it isn’t

So you're not living in a musical, but your heart rhythm is still out of sorts? There are a few reasons why this might be happening outside of arrhythmia. Some common triggers of heart palpitations are:

  • Stress
  • Anxiety
  • Panic
  • Lack of sleep
  • Fever
  • Low blood sugar
  • Smoking
  • Excessive consumption of caffeine
  • Excessive consumption of alcohol
  • Certain medications

If none of these apply to you then you might have a heart rhythm disorder (even if they do apply, you might still want to visit a cardiologist just to be safe!)

Illsutration of normal ECG and Atrial Fibrillation

One of the most common types of arrhythmia that results in heart palpitations is a condition known as Atrial Fibrillation, or AFib. In AFib, the heart rhythm in the top chambers is extremely fast and irregular, which leads to a disorganised and chaotic rhythm in the bottom chambers (pumping chambers of the heart). AFib should be treated as early as possible to prevent the development of more serious and deadly complications, such as a stroke. 

Other possible conditions that can lead to heart palpitations include supraventricular tachycardia, atrial tachycardia, and atrial and ventricular ectopic beats. Ventricular tachycardia and ventricular fibrillation are more serious forms of heart rhythm disorders that can present as palpitations or fainting spells and can lead to collapse or sudden death.

When should I see a doctor?

You  should see a doctor if your heart palpitations:

  • last for longer than a few seconds at a time
  • happen very frequently
  • are accompanied by shortness of breath, dizziness, fainting or chest pain. 

This is especially so if you have a family history of any heart conditions, such as arrhythmias, or if you have a history of pre-existing heart problems like a prior heart attack or a weak heart. 

During your first consultation, your cardiologist will ask you questions about your symptoms, your medical history, and your family medical history. This may be followed by a physical examination.

If your doctor suspects that your heart palpitations are caused by an underlying heart condition, he or she may perform various diagnostic tests to determine the cause of your palpitations. Examples of this include:

If your heart is well, you can rest assured knowing that your heart palpitations are truly nothing to worry about and that you’d probably just need to hold back on the coffee from time to time. However, if any of these tests come up positive, then it can be treated accordingly.

Treating heart palpitations

Heart palpitations are generally managed by treating the underlying cause of the palpitations. For atrial fibrillation, your cardiologist will discuss the various treatment options available for your condition. 

Atrial fibrillation can be effectively treated with an electrophysiology procedure called pulmonary vein isolation (Catheter ablation). This is a minimally invasive procedure that can be carried out as a day surgery procedure and involves the use of heat or cold energy to create tiny scars in small areas of the heart tissues that are responsible for the rhythm problems. 

Alternatives to the procedure include anti-arrhythmic drugs (AAD), which are used to maintain a normal rhythm. However, the efficacy of AADs to maintain sinus rhythm may not be as good and may come with side effects. In some patients with long-standing atrial fibrillation, taking medication to slow down the heart rate is also an option of treatment. These medications are called heart rate lowering medication. 

Patients with atrial fibrillation may also need blood-thinning medication to prevent stroke. Your cardiologist will work with you on discerning which medications would benefit you most after further discussion. 

If your heart palpitations are triggered by certain activities or emotions, you can also take steps to prevent them from occurring, depending on what those triggers are, such as practising relaxation methods or minimising your caffeine intake.

Summary

While heart palpitations can be harmless — and can even seem a little bit romantic — they can also be a sign of more pressing health conditions when they are prolonged or happen very frequently. If you suspect that your heart palpitations are caused by an underlying issue with your heart, you should seek medical treatment as soon as possible.

When it comes to the heart, prevention is always key. To keep your heart healthy and decrease your likelihood of developing any heart-related conditions, you should:

  • Exercise regularly
  • Eat a heart-healthy diet
  • Minimise stress
  • Limit your alcohol and caffeine consumption
  • Stop smoking, if you are a smoker

To find out more about heart palpitations or for general advice on how to keep your heart in peak condition, you should see a cardiologist who will be able to provide information on these topics and test for any possible issues with your heart.

How can we help you?

We offer consultation for a comprehensive range of and treatment plans.
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Dr Devinder Singh

Dr Devinder Singh

Senior Consultant Cardiologist &
Cardiac Electrophysiologist

Dr Devinder Singh is the Medical Director of Cadence Heart Centre. He is an experienced Senior Consultant Cardiologist & Cardiac Electrophysiologist with over 20 years of clinical experience.

His expertise lies in clinical cardiology, cardiac rhythm disorders (arrhythmia), cardiac pacing (including cardiac resynchronisation therapy) and cardiac magnetic resonance imaging. He performs electrophysiology studies and radiofrequency ablation of cardiac arrhythmias, and is well versed in pacemaker and defibrillator insertions.

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