Heart Arrhythmias and Palpitations: When to Worry?
An irregularly beating heart is not always serious.
Dr. Marc Dufresne
Cardiologist
Palpitations—that uncomfortable sensation of feeling your heart beat—are one of the most frequent reasons for cardiology consultations. In the vast majority of cases, they are benign.
Benign Arrhythmias
- Extrasystoles: premature beats felt as "skipped beats". Very common, often exacerbated by coffee, stress, or lack of sleep.
- Sinus tachycardia: normal acceleration of heart rate (exertion, emotion, fever).
Arrhythmias to Watch For
- Atrial fibrillation (AF): irregular and rapid atrial rhythm. Stroke risk multiplied by 5 if untreated.
- Ventricular tachycardia: potential emergency requiring immediate assessment.
- Symptomatic bradycardia: excessively slow rhythm with malaise, fatigue, or fainting.
When to Consult?
- Palpitations accompanied by shortness of breath or chest pain
- Malaise or loss of consciousness
- Prolonged episodes (> 30 minutes) of rapid and irregular rhythm
- Family history of sudden death
Additional Examinations
ECG (electrocardiogram) is the first examination. Holter (24-48h recording) captures intermittent arrhythmias. Connected watches can now detect atrial fibrillation with reasonable sensitivity.
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