Poems often wax lyrical about heart palpitations when you are in love, fluttering in your chest like delicate wings and so on. But when it is a medical problem it can be very serious. Here are some facts you may not know about irregular heartbeats, known more properly as cardiac arrhythmias.

  • Palpitations, when your heart beats faster than normal (a resting heartbeat of 50-70 beats per minute is now considered healthy) are normally not serious and can be caused by anxiety, smoking or drinking too much coffee. Your heart may feel like it’s pounding, fluttering or beating irregularly, which may last for several seconds.


  • An arrhythmia, on the other hand, often referred to as a heart murmur, is a problem in the electrical ‘wiring’ of the heart muscle, which causes a long-term noticeable change in the heartbeat.


  • Everyone’s heart beats at a different rate during the day. It will be slower when you’re at rest and faster when you are physically active. Anxiety and excitement can make it beat faster, too. A woman’s average heartbeat is faster than a man’s by almost eight beats a minute, even at rest.
  • Types of arrhythmia include atrial fibrillation (the most common type) when the heart beats irregularly and faster than normal; supra ventricular tachycardia, when you have episodes of abnormally fast heart rate at rest, and bradycardia, when the heart beats more slowly than normal. There is also heart block, when the heart beats more slowly than normal, which can cause people to collapse. Finally there is ventricular fibrillation, a rare, rapid heartbeat rhythm that rapidly leads to loss of consciousness and sudden death if not treated immediately.


  • In atrial fibrillation the heart’s upper chambers (atria) contract randomly, sometimes so fast the heart muscle can’t relax properly between contractions. This reduces the heart’s efficiency and performance. Symptoms include regular heart palpitations, often for a few seconds or possibly
    a few minutes, as well as tiredness and breathlessness.


  • Having atrial fibrillation means your risk of having a stroke is five times higher than for someone whose heart rhythm is normal.
    It is more common in older people but being overweight and drinking alcohol in excess increases your chance of developing the condition.

What are the options if AF strikes?

  • Drugs such as beta-blockers and verapamil, a calcium channel blocker, are often used; anticoagulant drugs such as heparin and warfarin are a standard treatment. These need regular monitoring but new drugs called ‘novel anticoagulants’ don’t need as much. These slow the heart and try to keep it in a normal rhythm.


  • Catheter ablation is a keyhole procedure where wires are passed to the heart through the veins at the top of the legs. These wires cauterise the inside of the heart to prevent the AF starting.


  • Cardioversion is a treatment that delivers a small, controlled electrical shock to the heart, to interrupt an arrhythmia and allow the normal electrical pathway to take over.


  • A pacemaker may be needed by some with irregular heart rates, to stimulate the heart beat.


  • An implantable cardioverter defibrillator (ICD) or a SIDC, is a small battery-powered device implanted under the skin that gives the heart electrical shocks.


Images: Shutterstock

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