Frequent Heart Palpitations What To Do

If you experience frequent heart palpitations or premature beats, it is important to take the right steps to manage and address the issue effectively. Palpitations can be concerning, but understanding the causes and treatment options can help reduce anxiety and improve outcomes.

Identify the Underlying Cause

The first step in managing frequent premature heartbeats is to visit a hospital or cardiologist to determine the root cause. One of the most critical aspects is to rule out any structural heart disease, which can be a serious underlying condition. A cardiac ultrasound, or echocardiogram, is often recommended to assess the heart's structure and function. This helps determine whether there are any abnormalities that could be triggering the premature beats.

Monitor with a 24-Hour ECG

Another essential diagnostic tool is the 24-hour Holter monitor. This device records your heart's electrical activity over a full day, allowing doctors to calculate the total number of premature beats you experience. If the number of premature beats exceeds 15% to 20% of your total heartbeats in a day, it may indicate a higher risk for complications, such as arrhythmia-induced cardiomyopathy.

When Intervention Is Necessary

If the Holter results show a high burden of premature beats, medical or procedural intervention may be necessary. One effective treatment option is radiofrequency ablation, a minimally invasive procedure that targets and eliminates the abnormal heart tissue causing the irregular rhythm. This procedure is especially useful for patients with a high frequency of symptoms or those at increased risk of developing heart muscle issues.

Medication Options

If the premature beats are less frequent and not causing significant symptoms, medication may be the first line of treatment. There are four main classes of antiarrhythmic drugs commonly used, including beta-blockers, propafenone, amiodarone, and non-dihydropyridine calcium channel blockers. Each medication has specific indications and potential side effects, so your doctor will tailor the treatment based on your individual condition and type of arrhythmia.

When No Treatment Is Needed

In some cases, if the number of premature beats is very low—such as fewer than 400 per day—and there are no associated symptoms or structural heart issues, no treatment may be necessary. In these situations, lifestyle modifications, regular monitoring, and stress reduction techniques may be sufficient to manage the condition without medication or procedures.