Causes and Potential Resolutions of Heart Palpitations

Based on an article titled “Instant electrocardiogram feedback with a new digital technique reduces symptoms caused by palpitations and increases the health-related quality of life (the RedHeart study)”

https://academic.oup.com/eurjcn/article/20/5/402/6162694?login=true

Original written by Carnlof et al., 2021

By Murielle Nsiela 

Palpitations are shared amongst many; they can cause anxiety and depression, resulting in reduced health-related quality of life.¹ They are described as rapid movements in the chest or the adjacent areas.² Some palpitations are stress-related and harmless. They can be caused by your body sending out electrical signals that make your heart beat faster.

Others can be caused by premature abnormal contractions of the heart's ventricles and atriums, known as premature atrial or ventricular contractions (PAC and PVC). These additional contractions occur sooner than the expected normal heartbeat. Other causes include arrhythmias (irregular heartbeat) which usually do not have much clinical significance. 

Additional factors such as physical activity, overworking, strong emotions (such as stress and anxiety), caffeine, tobacco and alcohol, hormone changes, and some medication can result in palpitations due to an elevated heart rate and stronger heart muscle contraction. These factors can also trigger PAC and PVC.

It is essential to differentiate between palpitations, panic attacks, and psychological disorders. It has been suggested that palpitations induce similar symptoms to both of these issues.³

The study by Carnlof et al. 2021 investigated the extent to which palpitations cause symptoms such as depression and anxiety, and the overall health-related quality of life in women. They also looked at whether direct feedback of the heart rhythm during palpitations can reduce depression and anxiety and improve health-related quality of life. The study was conducted on women only.

Other studies have suggested that women are more likely to be symptomatic and have a lower quality of life. Furthermore, it has been proven that women have less frequent clinical interventions than men.⁴^,⁵

The study found that 39% of participants were not taken seriously when consulting their healthcare provider about palpitations, and 16% had been diagnosed with either anxiety, stress or panic attacks. Palpitations resulting from anxiety are wrongly diagnosed or neglected by healthcare providers. The focus is more so on the anxiety and not the heart palpitations themselves; the actual causes of the heart rhythm are therefore ignored.

As a result, most people who are not taken seriously are less likely to seek a second opinion from a different healthcare provider.³ The results from the study found that having direct feedback enhances the patient’s sense of control, empowerment, and security when experiencing palpitations. 

Healthcare providers should thus offer their patients heart monitoring devices to monitor their heart rhythm, ensuring they are taken seriously, which can also reduce palpitations caused by anxiety. Furthermore, when the heart monitor reveals an issue of clinical importance, this can be a relief as it can be treated immediately. This can therefore improve the patient’s quality of life.

However, this process can be ineffective, as having a record of your heart rhythm during palpitations can lead to more anxiety.⁶ Therefore, it is crucial to find alternative ways to be at ease with heart rate monitors without increasing the chances of further palpitations.