Palpitations are the clinical manifestation of the heartbeat, that is, it is the way to feel the heartbeat. Usually the heart is not felt, except in some situations such as when exercising or in the case of some very intense emotion. Apart from these minor cases, most of the time palpitations are a symptom of an arrhythmia. Dr. Naiara Calvo, Cardiology Specialist at the Clínica Universidad de Navarra, answers the most common questions about palpitations and advises on when to go to the doctor.

Besides palpitations, can arrhythmias lead to other symptoms?

Sometimes they can lead to syncope or loss of consciousness. It is not very common, but when it does occur, the arrhythmias that cause syncope are due to a serious cause. Sometimes arrhythmias can also cause more nonspecific symptoms such as feeling short of breath.

Can we have an arrhythmia and not notice it?

Yes, sometimes arrhythmias are asymptomatic and are detected incidentally when doing a control electrocardiogram.

They are dangerous?

There are many types of arrhythmias, and most of them are not dangerous, as long as a proper diagnosis and treatment is established.

Are they always the result of heart disease?

Arrhythmias can appear in both healthy hearts and diseased hearts. That is, it does not necessarily have to exist a heart disease for some type of arrhythmia to appear.

And apart from a heart disease, what other things can cause them?

Stress or anxiety are a very common cause of tachycardia (fast heartbeat). The consumption of drugs, alcohol, tobacco or coffee, or even infections can also favor the appearance of arrhythmias.

Is it true that ovulation slows down the heart rate?

Certain physiological manifestations of the heart rhythm can occur during ovulation, but they are not medically relevant.

Are there any other factors that predispose to arrhythmias?

Yes, some of them would be high blood pressure, any type of heart disease, certain hereditary diseases, certain drugs, advanced age, obesity …

Can we talk about differences by sex or age?

In general, arrhythmias can appear at any age and occur in a similar proportion in both sexes. Although there are more frequent arrhythmias in older ages, such as atrial fibrillation, and other types of arrhythmias more frequent in young people and with healthy hearts such as supraventricular tachycardias.

If we notice any arrhythmia, is it necessary to go to the doctor?

Yes, in the presence of arrhythmias it is always advisable to consult a specialist so that he or she can determine if it is an occasional arrhythmia or if, on the contrary, it is due to something more serious.

What tests are usually done to find out if these arrhythmias are important or not?

Arrhythmias are diagnosed by an electrocardiogram, as long as they are present at the exact moment in which the test is carried out. In the case of occasional palpitations, it is advisable to carry out a Holter-ECG (it is a portable recorder that collects the pulsations continuously for a minimum of 24 hours) and many times it is also necessary to do an echocardiogram as a complement to know whether or not there is any heart disease.

Is it necessary to treat them?

Although on some occasions, arrhythmias are completely benign and no treatment is necessary, most of the time it is necessary to treat them, either with drugs or with the implantation of a device such as a pacemaker or an implantable automatic defibrillator, which it is used in the case of some serious arrhythmias.

What are the most common arrhythmias?

• Tachycardia . Paroxysmal supraventricular tachycardia usually begins abruptly, usually without any trigger. Most disappear spontaneously after a few minutes.
• Sinsual bradycardia . The heartbeat originates and is transmitted normally, but is slower than usual. It is common in people who exercise, without you having to worry.
• Extrasystole . It is a beat that is ahead of the usual rhythm of our heartbeats and is experienced as a jump in them. They are not usually more serious, although they can be annoying.
• Atrial fibrillation . It is the most common cardiac arrhythmia today. It is because the electrical impulse of the heart is not regular. It requires treatment as it prevents simple daily tasks.

Control your heartbeat

• How many are normal? We usually have between 60 and 80 per minute, although up to 100 is considered normal.
• During life . At birth we have an elevated heart rate and from the first month, it decreases until we reach the age of 20 and from then on it remains stable.
• Throughout the day . In the morning we have more pulsations than in the afternoon and while we sleep, they decrease a lot. after eating, the heart rate increases 10-30%.
• Personal characteristics . Both taller and thinner people have fewer beats per minute.

The latest findings

• Sleep apnea . A study carried out by researchers at the Hospital del Mar in Barcelona has shown that treating sleep apneas helps reduce arrhythmias in those who suffer from "atrial flutter", a type of cardiac arrhythmia that causes the heart to beat very fast.
• Intense exercise . Although exercise helps prevent cardiovascular diseases, a recent Spanish study has linked the practice of particularly intense and prolonged exercise over time with a greater probability of suffering from atrial fibrillation in the long term.