In some people, the heart is unable to maintain a normal beating rhythm, producing heart arrhythmias causing such manifestations as tiredness, breathlessness, and a feeling of being off-balance. Most report having a rapidly pounding heart in the throat or chest and may experience nausea. Often, treatment for palpitations requires nothing other than a change in lifestyle practices, while other times prescription drugs become necessary. Antiarrhythmic medications widen arteries or check reactions to adrenaline. A tiny electrical apparatus with wires surgically placed inside veins of the heart, the pacemaker is sometimes essential for those having recurrent difficulties with palpitations.
Several kinds of heart arrhythmias exist, they are most commonly referred to as tachycardia, which describes a heart that beats too quickly, or bradycardia, a delayed heart rhythm that is too slow. Atrial fibrillation is characterized by a fast, but ineffective rhythm causing deficient blood circulation. While palpitations may not be a threat to life, it can be critical and lead to brain damage or even death. Generally, it is the type of arrhythmia that determines treatment for palpitations.
Lifestyle changes are frequently incorporated into treatment for palpitations and can often be all that is necessary, especially in the absence of heart disease or structural abnormalities. Stress reduction therapies are usually recommended in the form of meditation, relaxation techniques, and tai chi quan. Dietary changes include decreasing caffeine consumption as well as alcohol and tobacco products. Certain drugs do act to boost the heart rate such as that found in non-prescription decongestants and illicit street drugs like marijuana, cocaine, and methamphetamine. Elimination of these substances is important to bring palpitations under control.
Drugs prescribed for heart palpitations, referred to as antiarrhythmics, fall into two separate categories of agents: calcium channel blockers and beta-blockers. Calcium channel blockers such as nifedipine and verapamil, work by decreasing blood pressure against arteries through causing arterial dilation. Such action permits the heart to function with a smaller amount of oxygen than normal, which provides for a significant reduction in the stress placed upon it, thus slowing the rate at which it contracts. Beta-blockers limit the body's adrenergic response, reducing heart beats and oxygen needs. One of the primary differences between these types of agents are that beta-blockers like propranolol and atenolol provide extra protection against subsequent heart attacks, while calcium channel blockers do not.
Pacemakers are small mechanical devices that help to manage contractions of the heart and prevent abnormal beating patterns. Requiring surgical placement, the pacemaker contains sensors capable of emitting electric surges when fibrillation or an abnormally fast or slow rate is sensed. Impulses work to prompt the heart back into its normal beating pattern. Also referred to as implantable cardioconverter defibrillators (ICD), pacemakers are used in treatment for palpitations only after other possible causes and treatment options have been ruled out and it has been determined that the occurrence of arrhythmia is persistent.