The heart is a two stage electrical pump. The upper chambers of the heart, the atria, (single=atrium) collect blood from the body and pump it into the lower chambers, or ventricles. There is a little delay for the ventricles to fill, and then they pump the blood out of the heart and back to the body. For this to happen in a coordinated fashion, the heart has its own electrical system.

Specialized electrical cells imbedded into part of the muscles in the atrium generate the electricity and act as a pacemaker for the heart. About 60-80 times a minute this pacemaker (the sinoatrial or SA node) fires and sends electrical signals to all of the atrial muscle cells allowing them to fire at once, generating the first half of a heart beat.

Electricity also travels to the ventricles but is held up for a split second in the junction between the atrium and ventricle at the atrio-ventricular (AV) node to allow the ventricles to fill with blood. The signal then travels through electrical bundles to allow all the muscle cells of the ventricles to fire at once, causing the second half of the heart beat. This pumps blood out to the body. After the heart pumps, there is another split second when the electrical system resets itself to get ready for the next electrical impulse cycle. This allows blood to return and fill the heart, getting ready for the next heartbeat.

Palpitation Symptoms

Palpitations are a symptom in and of themselves. They can be associated with an isolated "skipped beat" sensation or, if the palpitations are prolonged, there can be a feeling of fluttering or fullness in the chest. Sometimes patients describe a marked fullness in their throat associated with shortness of breath, and it may be difficult to decide if the fullness is due to palpitations or due to angina. This is especially so if the palpitations have subsided and are not present when the affected person seeks medical care. Prolonged episodes can be associated with chest pain, shortness of breath, sweating, and, nausea and vomiting. Some types of heart rhythm problems can cause lightheadedness or even passing out (syncope).

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Palpitations Treatment

Since there are numerous types of palpitations, the treatment is usually specific to the diagnosis. In those people with a yet undiagnosed palpitation, minor lifestyle changes may help minimize symptoms. These include stopping the use of caffeine, alcohol, and OTC cold medications.

Patients with palpitations should try to keep a journal of when, where, and what circumstances surround their palpitations. They should learn how to take their pulse and document their pulse rate, whether the palpitations occur in isolation or in a pattern, and what associated symptoms exist, including lightheadedness, nausea, sweating, chest pain, or shortness of breath. It is most important to note whether the heart beat is regular or irregular and whether it is fast or slow.

Chest pain (or any other signs of heart attack including jaw pain, indigestion, or extreme fatigue), shortness of breath, or passing out should prompt the affected person or family member/friend/caregiver to call 911 and seek medical attention immediately.


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