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Arrhythmia (palpitations) Q&As

Published by Bupa's health information team, April 2009.

Answers to questions about arrhythmia (palpitations)

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

Sometimes my heart skips a beat and thumps. What is this and do I need treatment?

Sometimes you may feel like your heart has missed a beat or suddenly thumps. This is an ectopic heartbeat. Ectopic beats don't usually cause problems but they can be a sign of a more serious condition.

Explanation

An ectopic beat occurs when your heart beats too soon and then pauses before beating again so that it returns to the normal rhythm. Ectopic beats are completely harmless and don't usually need treatment.

Ectopic heartbeats are very common and you may not notice if you have one. Healthy people can have more than 10 ectopic beats per hour. If you're having very frequent ectopic beats - more than 10 per minute - or if you have any other symptoms, such as chest pain, you should see your GP.

Very rarely, ectopic beats can be caused by an underlying heart problem such as:

  • having had a heart attack
  • heart disease
  • reduced blood supply to your heart - this can be caused by heart disease and other conditions

If your ectopic beats are very frequent, or if you have other signs of heart disease, your GP may refer you to a cardiologist (a doctor who specialises in identifying and treating conditions of the heart and blood vessels).

Further information

Sources

  • Ectopic heartbeats. Medline Plus. http://medlineplus.gov, accessed 9 May 2008
  • Longmore M, Wilkinson IB, Rajagopalan S. Oxford Handbook of Clinical Medicine. 6th ed. Oxford: Oxford University Press, 2004:132
  • Personal communication, Dr Tim Cripps, Consultant Cardiologist, Bristol Royal Hospital, 4 June 2008
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I think my medicine is affecting my heart rate - should I stop taking it?

No. You shouldn't stop taking a prescription medicine without asking your GP first. If you're taking an over-the-counter medicine, ask your pharmacist for more advice.

Explanation

Everyone experiences some variation in their heartbeat and you may occasionally feel a palpitation. A palpitation is an unpleasant awareness of your heartbeat, often described as a thumping in your chest.

An arrhythmia is a disturbance of the normal electrical rhythm of your heart. Arrhythmias may occur continuously or just occasionally.

Certain medicines can cause arrhythmias such as those listed below.

  • Beta-blockers, used to treat some heart conditions, can cause a very slow heart beat.
  • Calcium-channel blockers, used to treat high blood pressure, can cause palpitations (an unpleasant awareness of your heartbeat) due to sinus tachycardia - this is when your heartbeat is faster than usual.
  • Levodopa, a medicine used to treat Parkinson's disease, can cause sinus tachycardia.
  • Beta-2 agonists (such as salbutamol) used to treat asthma can cause sinus tachycardia.
  • Some over-the-counter cough and cold medicines that contain pseudoephedrine hydrochloride (eg Sudafed) can cause tachycardia. If you have a heart condition or blood pressure problems, you should be careful about using over-the-counter cold remedies. Always read the patient information that comes with your medicine and if you have any questions, ask your GP or pharmacist for advice.

Often these medicines only cause arrhythmias in people who have had a previous heart problem such as a heart attack or previous arrhythmia. It's rare that they cause arrhythmias in people who don't have heart problems.

With some types of arrhythmia you may not get any symptoms. If you do get symptoms, they will depend on the type and severity of your arrhythmia. If you develop symptoms such as palpitation, dizziness or chest pain, then you should visit your GP. He or she will be able to tell you if you have an arrhythmia and advise you of any further treatment necessary.

If you think your medicine is causing an arrhythmia, then you should ask your GP or pharmacist for more advice. Always read the patient information leaflet that comes with your medicine.

Sources

  • Longmore M, Wilkinson IB, Rajagopalan S. Oxford Handbook of Clinical Medicine. 6th ed. Oxford: Oxford University Press, 2004:96; 126-134
  • Joint Formulary Committee, British National Formulary. 54th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2007: 146; 176; 201; 259
  • Tachycardia. Arrhythmia Alliance. www.heartrhythmcharity.org.uk, accessed 30 March 2008
  • Palpitation. British Heart Foundation. Heart Information Series Number 14, 2005. www.bhf.org.uk
  • Personal communication, Dr Tim Cripps, Consultant Cardiologist, Bristol Royal Hospital, 4 June 2008
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Can I drive if I have an arrhythmia?

If you have an arrhythmia, you're allowed to drive as long as you don't have any symptoms. If you have surgery to treat your arrhythmia, you will need to stop driving until you have recovered.

Explanation

If you have an arrhythmia, you must stop driving if it causes you any symptoms such as feeling dizzy or being short of breath. You should see your GP for advice as you may need to change your treatment. Once your symptoms have been controlled for at least four weeks you may be able start driving again but discuss this with your GP who will be able to interpret the DVLA rules.

If you have surgery to treat your arrhythmia, you will have to stop driving for some time depending on what treatment you had.

For example, if you had a catheter ablation or pacemaker implanted, you only need to stop driving for one week as long as you have no other conditions that prevent you from driving. However, if you had an implantable cardioverter defibrillator operation, you will have to stop driving for between one and six months depending on the severity of your condition. This ensures that your arrhythmia is controlled and you won't be a risk to yourself or other drivers.

If you're in any doubt about driving, always follow your doctor's advice and contact your motor insurer so that you're aware of their recommendations.

Further information

Sources

  • At a glance guide to the current medical standards of fitness to drive. DVLA, 2008. www.dvla.gov.uk
  • Longmore M, Wilkinson IB, Rajagopalan S. Oxford Handbook of Clinical Medicine. 6th ed. Oxford: Oxford University Press, 2004:96; 126-134
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Related topics

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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: April 2009

 

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