Causes And Consequences Of Heart Palpitations

Heart palpitations, also known as premature heartbeats, are a common type of arrhythmia. They can be classified into three categories on an electrocardiogram (ECG): atrial premature beats, ventricular premature beats, and junctional premature beats. In most cases, these changes are benign and do not have a specific cause. Ventricular premature beats may occur due to an early electrical impulse from a specific point in the ventricle. Some individuals may not experience any symptoms, while others may feel heart palpitations or irregular heartbeats.

Understanding The Causes

There are various reasons behind premature heartbeats. In many cases, they are harmless and may occur in healthy individuals without any underlying heart disease. However, certain conditions such as stress, excessive caffeine or alcohol intake, smoking, fatigue, or electrolyte imbalances can contribute to their occurrence. In some cases, structural heart disease or previous heart damage may be the underlying cause.

Assessing The Consequences

Although most premature heartbeats are benign, frequent or complex cases may lead to complications. In rare cases, ventricular premature beats can trigger more dangerous arrhythmias like ventricular tachycardia or ventricular fibrillation, which can be life-threatening. It's important to evaluate the overall heart function and determine if there is any structural abnormality that may be contributing to the arrhythmia.

Diagnostic Evaluation

Echocardiogram: This imaging test helps assess the structure and function of the heart. It can detect any abnormalities such as cardiomyopathy or valve dysfunction that might be contributing to the premature beats.

24-hour Holter Monitoring: A portable ECG device records the heart's rhythm over a 24-hour period, providing valuable data on the frequency and pattern of premature beats.

Treatment Options

Monitoring And Observation

If the premature beats are infrequent and not associated with symptoms or structural heart disease, no treatment may be necessary. Regular follow-up with a healthcare provider and periodic echocardiograms or ECGs may be sufficient to ensure the condition remains stable.

Catheter Ablation

For patients with frequent ventricular premature beats or those experiencing symptoms, catheter ablation may be recommended. This procedure involves locating the origin of the abnormal beats and using heat or cold energy to destroy the small area of heart tissue responsible for the irregular rhythm. Patients may need to undergo periodic cardiac evaluations every six months or annually to monitor heart size and function before considering ablation.

Implantable Cardioverter Defibrillator (ICD)

In rare cases where premature beats can trigger dangerous arrhythmias such as ventricular tachycardia or fibrillation, an implantable cardioverter defibrillator (ICD) may be necessary. This device continuously monitors the heart rhythm and delivers electrical shocks if a life-threatening rhythm is detected. It is often combined with medication or ablation therapy for optimal control of the arrhythmia.