Skipping a beat

Many people experience racing or skipping heartbeats from time to time. But some irregular heartbeats or palpitations can be a sign of a serious heart condition.

“The heart is like a machine, and when it’s out of rhythm, it’s not working efficiently,” said Aaditya Vora, MD, a cardiac electrophysiologist (heart rhythm specialist) with Baptist Heart Specialists. “That’s because the heart isn't receiving its normal amount of blood flow. Sometimes, it’s a harmless episode that can be treated conservatively, or it can be a sign of a larger underlying heart rhythm disorder.”

Common causes of heartbeat fluctuations

A normal adult heart beats between 60 and 100 times per minute, and typically rises during exercise and slows down during rest or sleep.

While heart palpitations can sometimes be a sign of heart disease, more often they're due to non-heart-related causes that can occur for a variety of reasons, such as:

• Consuming beverages high in caffeine
• Eating large quantities of chocolate
• Drinking too much alcohol
• Taking over-the-counter cold remedies containing stimulants
• Being overly fatigued, stressed, or not sleeping

Symptoms beyond irregular beats

Frequent heart palpitations can cause fatigue before other symptoms show up.

“Someone may not realize their heart is out of rhythm. Sometimes they just feel tired or lack energy,” said Dr. Vora.

Individuals who experience more serious symptoms such as extreme lightheadedness, chest pain, shortness of breath, or loss of consciousness should be tested to find out if their heart’s electrical signals aren’t going through the normal pathways.

“Their symptoms help us characterize what's going on and determine if intervention is needed," Dr. Vora said.

How palpitations are evaluated

“The most effective way to diagnose an irregular heartbeat or arrhythmia is with an electrocardiogram or EKG to measure the timing and duration of each electrical phase in the heartbeat,” said Dr. Vora. “Wearable devices like a Holter monitor or an event recorder can detect the heart’s normal activity or any sporadic arrhythmias.”

Built-in EKG technology in today’s smart watches has also helped electrophysiologists make more timely heart rhythm diagnoses.

AFib and ablation

Once a cardiac electrophysiologist determines what kind of abnormal heart rhythm someone is having, he or she can begin to treat it with a variety of techniques, from simple lifestyle changes to something more complex like catheter ablation, a minimally invasive procedure to cure atrial fibrillation (AFib).

“Atrial fibrillation is by far the most common heart rhythm problem we treat,” said Dr. Vora. “When it occurs, patients can lose up to 20% of their blood flow, which can lead to their heart beating very inefficiently. Left undetected, AFib can drastically increase a person’s risk of stroke or heart failure.”

According to the National Blood Clot Alliance, one in every six strokes in the United States is caused by AFib. By 2030, it's estimated that more than 12 million people in the U.S. will have AFib, the Centers for Disease Control and Prevention reports.

Dr. Vora said most patients treated with catheter ablation in a hospital-based facility, like Baptist Heart Hospital’s state-of-the-art Heart Rhythm Center can go home the same day.