How to treat heart palpitations?

Every each of us will experience heart palpitations once in a while whether it is because an examination is coming or simply going for an interview. Heart palpitations can mean a lot of things ranging from normal palpitations to life-threatening heart conditions. In some people, heart palpitations or simply palpitations for short is a symptom of heart disease particularly the electrical conductivity of the heart muscle.

There is no one solution to treat palpitations as different causes need different treatments. However, palpitations can be treated symptomatically (treating the symptoms only) or treating the cause itself it is known. There are several causes of pathological or abnormal palpitations. These include:

  1. Heart Block - can be further divided into 4 types
  2. Escape Rhythm - where there is abnormal heartbeat in the middle of normal beats
  3. Narrow Complex Tachycardia - this is an umbrella term of several types of fast heartbeat with a characteristic of short section found on ECG reading
  4. Broad Complex Tachycardia - also a type of fast heartbeat but with wider section found on the ECG reading and usually more dangerous
  5. Syndromic Heart Disease - example like Brugada Syndrome, Wolf-Parkinson-White Syndrome

To treat Narrow Complex Tachycardia, the doctor will ask the patient to do a “vagal manoeuvre”. This is to enable the patient’s own body to decrease the heart rate by stimulating the vagus nerves. The doctor will also use medication that blocks or slow-down the conductivity of the heart. These medications include:

  1. Adenosine - this drug blocks conduction in the atrioventricular node and also dilate the blood vessels
  2. Beta-Blocker - as the name suggests, this group of medication act on the beta-receptor that is located in the heart muscle to slow-down the heartbeat
  3. Calcium-Channel Blocker - this type of medication works to block the fast heartbeat as well as to dilate the blood vessels
  4. Digoxin - this is also a drug that acts on the electrical conductivity of the heart, causing slowing-down of the fast-paced heartbeat

Depending on the severity of the condition and the type of palpitation the patient is experiencing, some of them will likely need to have electrical cardioversion which is a procedure of shocking one’s heart with an external electrical source. It is done in setting where the patient is unconscious, have low blood pressure, showing the signs of heart failure and have a dangerously high heart rate. This procedure can also be conducted in elective setting for example in the treatment of atrial fibrillation which a form of Narrow Complex Tachycardia.

For patients with Broad Complex Tachycardia, their choice of medications are a bit different in which the medications used are on different class like lignocaine and amiodarone.

Other treatments of palpitations for the heart block types are usually treating the causes first like hypothyroidism, low potassium in the blood, viral infection or infective endocarditis and heart block due to medication. For some people with heart block, medications are needed like atropine or the use of pacemaker whether permanently or temporarily.

Surgery also has its role in treating palpitations particularly with a condition such as atrial fibrillation and Wolf-Parkinson-White Syndrome where ablation (destruction) of certain part of the heart muscle is usually being performed in therapy-resistant palpitation.

In a nutshell, constant or recurring heart palpitations are something that people should not overlook at. As stated earlier, various pathological and life-threatening conditions can cause palpitations and hence the need for medical consultation. If you or anyone you know has recurrent palpitations, you can also ask a doctor online or go to the nearest clinic for further check-up.

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