A blog by Thomas Boto, co-founder of Natural Rhythm
Like many of you, the first thing I did when I first realized that my heart was skipping a beat was look online for what was happening to me. And, yep, my suspicions were confirmed…I was going to die. At least that what every website seemed to tell me. I’m sure there were statements about most palpitations being harmless, but all I read were the parts about having a heart attack or my heart stop beating and falling over dead. WebMD is great for some things I’m sure, but checking symptoms is not one of them. All roads seem to lead to disease or death.
Most Palpitations are Harmless
So before we go any further, I just want to make it clear that MOST HEART PALPITATIONS ARE HARMLESS. And this isn’t jet me talking, this is according to the National Heart, Lung and Blood Institute. There are some very serious medical conditions that can cause heart palpitations, so that is obviously where the confusion, terror, anxiety, and panic come in.
But don’t panic. If you are having chest pains or are dizzy, light headed, or have shortness of breath, by all means, seek medical attention and get checked out to be safe. But if you have already been down that road before or you are just noticing a few occasional palpitations without any other symptoms, remember that for the vast majority of us our palpitations are harmless and not life-threatening.
The Difference Between Palpitations and Irregular Heartbeats
Did you know that there is a difference between heart palpitations and an irregular heartbeat (or “Cardiac Dysrhythemia)? I didn’t. A heart palpitation is the subjective sensation one gets when that person feels an change in the regular beating of their heart. Often times it is accompanied by an increased heart rate, dizziness, or difficulty breathing. An irregular heartbeat, on the other hand, is when there is actually something wrong with the rhythm of the heart. In other words, an irregular heartbeat may cause heart palpitations, but not all heart palpitations are irregular heartbeats. So a person may have irregular heartbeats but may not have palpitations. Likewise a person may have heart palpitations but not heart irregularities.
The Different Types of Irregular Heartbeats
I won’t go into too much detail about the different types of irregular heartbeats since you can find this information all over the web (and I am by no means a medical professional). As a matter of fact, it is probably the first thing you read about when you look up heart palpitations. But I wanted to list them out so we can all be aware of the terminology since there are many of us here on this site with different causes of our palpitations. This is a very simplified, plain english version of each term:
- Premature Atrial Contractions (PACs) occur when electrical cells in the atria begin to fire an electrical signal telling the heart muscle in the atria (the top chambers of the heart) to contract before it’s supposed to (our normal electrical impulse signal comes from the Sinoatrial (SA) node – our God-given pacemaker). This causes the pause, flutter, palpitation, or whatever you want to call it. PACs are fairly normal and generally harmless unless you have an underlying health issue like heart disease.
- Premature ventricular contractions (PVCs) are premature heartbeats that come from the ventricles (the lower chambers) of the heart. Right after a premature ventricular contraction, our heart’s electrical system resets which causes a brief pause making it seem like our heart stops beating for a second. Like PACs, PVCs are fairly common and can occur in normal hearts. Absent any major issues with your heart (like heart disease or structural issues), PVCs are generally harmless.
- Atrial Fibrillation (A-Fib) is when there is random, chaotic electrical activity in the atria along with irregular, rapid beats from the ventricles. With A-Fib, the atria just quivers instead of pumping regularly, which means the ventricles can’t pump as much blood.
- Atrial Flutter (A-Flutter) is like atrial fibrillation except that the rapid electrical impulses occur in a regular pattern, rather than a chaotic, uncoordinated manner. Often times, atrial flutter evolves into atrial fibrillation.
- Supraventricular Tachycardia (SVT) is an abnormal fast heart rhythm that starts in atria (the upper chambers) of the heart. SVT is often an generic term for any arrhythmia that originates above the ventricles. With supraventricular tachycardia, abnormal electrical impulses cause the heart to beat too fast. Generally, with SVT, the heart beats faster than 100 beats per minute, but usually returns to a normal rate (60 to 100 beats per minute) on its own or with treatment.
- AV Nodal Reentrant Tachycardia (AVNRT) is a type of tachycardia (fast rhythm) of the heart that occurs above the Bundle of His (just a term for a group of heart muscle cells located near the center of the heart). It is the most common type of supraventricular tachycardia (SVT).
- Paroxysmal Supraventricular Tachycardia (PSVT) is a rapid heart rate, which begins and ends suddenly. The electrical impulse comes from a place above the ventricles (the lower chambers of the heart). PSVT mostly occurs in young people and infants.
- Non-Sustained Ventricular Tachycardia (NSVT) are simply short bursts of an accelerated heartbeat (three or more in a row). This is fairly common for people to experience.
- Paroxysmal Atrial Tachycardia (PAT) is a rapid, regular heartbeat originating in the atrium (upper chamber of the heart). PAT is an arrhythmia where the abnormality is in the electrical system of the heart, rather than the heart muscle or valves. PAT generally begins and ends abruptly and is rarely life-threatening, can cause lightheadedness, chest pain, anxiety, sweating and shortness of breath.
- Postural orthostatic tachycardia syndrome (POTS) is when an abnormally large increase in heart rate occurs after a person changes from the laying down position to an upright position. POTS is generally non-life threatening, but can be disabling and debilitating at times.
- Ventricular Fibrillation (VF or V-Fib) is a very rapid, uncoordinated, ineffective series of contractions throughout the lower chambers of the heart (ventricles). This is the really bad arrhythmia since it is often fatal. The ventricles begin to quiver and not pump blood. You would generally know if you have Ventricular Fibrillation since it is a form of cardiac arrest.
- Ventricular Tachycardia (VT or V-Tach) is a rapid heart beat (at least 100 beats) that originates in one of the lower chambers (the ventricles) of the heart. Rapid ventricular beats are more serious than rapid atrial beats since they make the heart extremely inefficient and tend to result in more severe symptoms.
As you read the definitions above, keep in mind that it is nearly impossible to diagnose our own irregular heartbeat. So be sure you go to a Cardiologist and let them run tests to rule out anything serious. My cardiologist found that I have premature atrial contractions and premature ventricular contractions.
How about you? What type of irregular heartbeat do you have?