How To Treat Palpitations

Palpitations can be a concerning experience, often described as a racing, fluttering, or irregular heartbeat. While occasional palpitations are normal, persistent or severe episodes may indicate an underlying condition that requires medical attention. The treatment of heart palpitations largely depends on identifying and addressing the root cause, which can vary from lifestyle factors to serious cardiac conditions.

Identifying the Underlying Cause

One of the first steps in managing palpitations is to determine what is causing them. Common causes include stress, anxiety, excessive caffeine or alcohol consumption, hormonal changes, and certain medications. However, more serious conditions such as coronary artery disease, cardiomyopathy, heart failure, and arrhythmias can also lead to palpitations. In children, asthma medications or exposure to stimulants like beta-agonists can trigger similar symptoms. A thorough medical evaluation, including an electrocardiogram (ECG) and possibly a Holter monitor, may be necessary to pinpoint the exact cause.

Targeted Treatment Based on Arrhythmia Type

Once the underlying cause is identified, treatment can be tailored accordingly. For example, if a patient experiences paroxysmal supraventricular tachycardia (PSVT), immediate interventions such as vagal maneuvers or intravenous medications like adenosine may be used to restore normal heart rhythm. In cases of frequent atrial premature beats or atrial tachycardia, antiarrhythmic medications may be prescribed to control the rhythm and prevent episodes.

Managing Ventricular Arrhythmias

When palpitations are caused by ventricular tachycardia, prompt treatment is essential. This may involve the use of antiarrhythmic drugs or, in more severe cases, cardioversion or catheter ablation. It's also crucial to address any underlying heart disease that may be contributing to the arrhythmia, such as ischemic heart disease or structural heart abnormalities.

Addressing Bradycardia and Conduction Disorders

For individuals experiencing palpitations due to bradyarrhythmias—such as sick sinus syndrome, high-grade atrioventricular (AV) block, or third-degree heart block—treatment may involve the implantation of a pacemaker. These devices help regulate heart rate and prevent symptoms associated with slow heart rhythms.

Lifestyle Adjustments and Long-Term Management

In addition to medical interventions, making lifestyle changes can significantly reduce the frequency and severity of palpitations. Avoiding known triggers such as stimulants, managing stress through relaxation techniques or therapy, maintaining proper hydration, and engaging in regular physical activity can all contribute to better heart health. Regular follow-ups with a healthcare provider are also important to monitor any ongoing conditions and adjust treatment plans as needed.