This is one of the commonest symptoms experienced by patients that prompt them to seek the advice of a cardiologist. People often describe these in a variety of different ways: ‘my heart keeps skipping a beat’ ‘my heart is beating fast’ ‘my heartbeat feels strange’ or ‘my heart feels like it has stopped’. All these symptoms are universally described as ‘palpitations’ although they can mean a variety of different things.
What do people who have these symptoms of an abnormal or funny heart beat actually have? It could be a number of different things. The commonest cause after thorough investigations are that there is nothing wrong and reassurance can be provided. The other common reason can be a person experiencing ‘ectopic beats’. These are extra heartbeats that are generated from a different part of the heart compared to normal. The important thing to remember about ectopic beats is that they are almost always completely normal. Every person will have a few ectopic heart beats throughout the day. Some people do notice them more than others and when this happens it can cause alarm and anxiety. On rare occasions, a large number of ectopic heartbeats can cause weakness of the heart muscle or they can indicate underlying serious heart problems. The less common causes of an abnormal heartbeat are a group of conditions known as ‘cardiac arrhythmia’. There are a number of different types of arrhythmia ranging from supraventricular tachycardia (SVT for short), atrial flutter, atrial fibrillation or ventricular tachycardia.
Abnormal heartbeat or palpitations can be diagnosed in a number of different ways. First and foremost it is important to get a good history of the symptoms – when they started, how frequently they occur, whether there are any other accompanying symptoms such as chest pain or breathlessness. A normal 12 lead ECG can also be useful in providing clues as to the underlying cause. Similarly, an echocardiogram is also a very useful test because it can provide vital information on how well the heart is beating. The most important test however, is continuous ECG monitoring. Depending on how often a person’s symptoms occur depends on how long the monitor is attached for. For daily symptoms a 24-hour recording is sufficient. If symptoms do not occur every day then 48hour, 72 hour or 5-day continuous recordings are possible. There is also a device called a Cardiomemo. While continuous ECG monitoring involves attaching sticky electrodes to a patient’s chest a Cardiomemo is a small device that is carried around and pressed on the person’s chest when they get symptoms. Finally, for longer periods of recording, there is the Zio Patch or even an Implantable Loop Recorder. The Zio Patch is a sticky patch that contains an ECG recording device that a person can wear continuously for 14 days. The patch is then removed and sent off for analysis. The Implantable Loop Recorder is a device that is surgically implanted under the skin and can monitor a person’s ECG for up to 3 years.
At the very least for a person who is experiencing abnormal heart beats it is worth getting an assessment by a cardiologist. Most arrhythmias are easily treatable and if the tests suggested above are all normal it can provide a great deal of reassurance. If you are experiencing abnormal heart beats and would like a further assessment you can book an outpatient appointment with Dr. Hamaad, private consultant cardiologist with over 10 years experience diagnosing and treating heart conditions.
