Normally we are not aware of our heart beating.  However, occasionally we are and this is called a palpitation and it is quite common to experience  this. Most of the time palpitations are entirely normal and not dangerous, sometimes they are abnormal and can be potentially dangerous.  An arrhythmia is an abnormal heart rhythm and it can be sensed as a palpitation.

 

Symptoms
People who experience palpitations describe them as a fluttering or a missed beat.  Occasionally people describe their heart as if it is beating out of their chest and this can be a regular rhythm or totally chaotic in nature.  Occasionally patients are not aware at all of their palpitation even though they may be in an arrhythmia. Some patients feel hot, sweaty, breathless, dizzy or even faint. Some patients with palpitations can black out or even have a cardiac arrest.

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Causes
There are a number of different causes of palpitations  or arrhythmias. Some of these are listed below:

• Ectopic beats – extra beats arising from the upper (atria) or lower (ventricle) chambers of the heart

• Non-sustained atrial run – a short run of extra beats arising form the atria

• Non-sustained ventricular run –a short run of extra beats arising from the ventricles.

• Atrial fibrillation – a common arrhythmia arising from the atria

• Atrial flutter –  a common arrhythmia usually arising from the right ventricle

• SVT – supraventricular tachycardiac – a fast heart rhythm usually arising from the top chambers in the heart and caused by a short circuit around the conducting system in the heart

• Ventricular tachycardia – a fast rhythm arising from the lower chambers in the heart

• Ventricular fibrillation – a fast and dangerous heart rhythm arising form the lower chambers of the heart.

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Investigations
ECG or electrocardiogram is an electrical reading of the heart that is performed by placing electrode stickers on the skin of the chest wall.

Ambulatory ECG or 24 hour ECG – this test is usually undertaken to identify whether there are any heart rhythm abnormalities during a 24-hour period. The test involves placing four electrodes onto the skin on the chest wall and the signals are recorded by a little computer worn like a belt and  the results are analysed later.

Prolonged ECG recording - this test is usually undertaken to identify whether there are any heart rhythm abnormalities during a prolonged  period. This may be a week or even longer depending on the type of recorder used.

Implantable loop recorder – this is a miniaturised electronic recording system that records the electrical signals from the heart and saves them to hard disc for subsequent analysis.

Ultrasound of the heart or echocardiogram is a test used to assess the structure and function of the heart