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What It Means When A Heart Skips A Beat?

Arrhythmias can occur without producing any symptoms or they produce a fluttering or pounding in the chest (awareness of ones heart beats can be quite distressing)

On an average, your heart beats about 100,000 times per day, everyday, without taking a break! A break in the regularity of the heartbeats is called an Arrhythmia.  


Arrhythmias can occur without producing any symptoms or they produce a fluttering or pounding in the chest (awareness of ones heart beats can be quite distressing). They can occasionally lead to feeling giddiness, blackouts and even having an episode of unconsciousness. Nevertheless, not all irregular heartbeats are life-threatening, nor do all require treatment.


Irregular heartbeats can be in the form of Tachyarrhythmias (heart beating too fast) or Bradyarrhythmias (heart beating too slow). 


The most common cause of arrhythmias is Premature Beats where an irregular impulse originates in the upper or lower heart chambers stimulating the heart to contract. They can be completely benign and harmless or maybe associated with underlying abnormalities such as disturbances in electrolytes like potassium, calcium or magnesium, thyroid abnormalities, infections, heart blockages, weak enlarged hearts, problems with the heart valves or side effects of concomitant medications.  They can also be produced by consumption of excess caffeine, alcohol and other recreational drugs. If these are not associated with underlying abnormalities or do not produce any symptoms, they need no special medications.  


Occasionally, a skipped heart beat or fluttering in your chest or feeling your heart beats may be associated with a tachyarrhythmia. Tachyarrhythmias can be in the form of disorders like atrial fibrillation, supraventricular tachycardias or ventricular tachycardias. These can make the heart beat uncomfortably at a very high rate in a regular or irregular rhythm. They can lead to symptoms of palpitations, giddiness, unconsciousness, strokes and even sudden death. 


Whenever you have a doubt about abnormal heartbeats the test of choice is an electrocardiogram (ECG).  The ECG is a simple, fast and inexpensive way to give us information about the rhythm, the rate, the irregularity, and the underlying causative factors.  Sometimes more tests are needed such as blood tests, Holter testing (24 hour ECG monitoring) or 2D Echocardiography (sonography of the heart). A special test for determining some rhythm disturbances is an Electrophysiology Study where some tubes are placed at special areas in the heart to detect the exact location or source of the fast heart beats. 


The options available to treat tachyarrhythmias include medications to slow down the heart beats, medications to change the rhythm from irregular to regular and blood thinners in several cases. Other modalities include radio-frequency ablation where the abnormal culprit pathway in the heart is destroyed by heat energy.  Occasionally a device is needed to be implanted called an automated implantable cardioverter-defibrillator (AICD) which detects rapid heart beats and delivers a life-saving shock to abort the arrhythmia.


The best way to keep your heart healthy and prevent the arrhythmias is to eat a healthy diet, rich in fruits and vegetables, exercise daily for 30-45 minutes, avoid smoking, alcohol, excess caffeine and other recreational drugs and to have a regular check-up of your heart.  


The first step to solve a problem is to recognize that it does exist!  So when you feel that skipping a beat or a flutter or a strange sensation in your heart, even it is for a fleeting moment, don’t neglect it. Get an ECG. 


Disclaimer: The views expressed in the article above are those of the authors' and do not necessarily represent or reflect the views of this publishing house. Unless otherwise noted, the author is writing in his/her personal capacity. They are not intended and should not be thought to represent official ideas, attitudes, or policies of any agency or institution.


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Dr. Nihar Mehta

The author is a Full-Time Consultant Cardiologist working at Jaslok Hospital and Research Centre since the last 6 years. I have received special training in Echocardiography and Interventional Cardiology as well as Cardiovascular Imaging.

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