Suppiramaniam Sreeharikesan

Our hearts beat more than 100,000 times a day, often without us giving them a second thought. But when that steady rhythm feels irregular — fluttering, racing, or skipping — it can be unsettling and may be a sign that something isn’t right.

These sensations, known as heart palpitations, are common and often harmless, especially when they occur once in a while. However, frequent or intense palpitations may signal a heart rhythm disorder, or arrhythmia, that should be evaluated by a medical professional.

Understanding

Arrhythmias

Arrhythmias occur when the heart beats too slowly (bradycardia), too quickly (tachycardia), or irregularly. While nearly everyone experiences an occasional skipped beat, recurring rhythm problems can be bothersome and sometimes dangerous.

Everyone’s normal heart rate is different. For most adults, a resting heart rate between 60 and 80 beats per minute is typical, while physically fit athletes may normally have rates as low as 40. Palpitations that occur frequently or are accompanied by symptoms such as shortness of breath, dizziness, chest discomfort, or fainting are reasons to seek care.

Diagnosing a Rhythm Problem

Palpitations and arrhythmias often appear suddenly and disappear just as quickly. Common triggers include dehydration, stress, illness, low blood sugar, or too much caffeine or alcohol. Because symptoms may stop before you reach a doctor’s office, your description of how the palpitations feel, how often they occur, and what you were doing at the time is an important part of the diagnosis.

Doctors may use blood tests, an electrocardiogram (ECG), or longer‒term monitoring with wearable devices, such as a Holter monitor, to detect abnormal heart rhythms that aren’t caught during a brief office visit.

Why Atrial Fibrillation Matters

One of the most common arrhythmias is atrial fibrillation (AFib). AFib occurs when faulty electrical signals cause the heart’s upper chambers to beat out of sync. This can result in a fast, irregular heartbeat and reduce the heart’s ability to pump blood effectively.

If left untreated, AFib significantly increases the risk of stroke, blood clots, and heart failure. Early diagnosis and appropriate treatment can help control symptoms and greatly reduce these risks.

Treatment Options for AFib

AFib treatment varies based on symptoms, risk factors, and overall health. Options may include:

— Blood thinners to reduce stroke risk

— Medications to control heart rate or rhythm

— Cardioversion, which uses electrical energy to restore normal rhythm

— Catheter ablation, which targets tissue causing abnormal electrical signals

— Appendage closure devices, such as Watchman or Amulet, for patients who can’t tolerate blood thinners

Some patients may also benefit from hybrid ablation, which combines surgical and catheter‒based approaches.

A New Option: Pulse Field

Ablation

A newer treatment now available locally called pulse field ablation (PFA) offers an important advancement in AFib care.

Unlike traditional ablation techniques that use heat or cold, PFA delivers short bursts of high‒energy electrical pulses through a catheter. These pulses precisely target the heart cells responsible for abnormal rhythms while better preserving nearby structures such as the esophagus and phrenic nerve. This increased specificity may reduce the risk of certain complications.

PFA is minimally invasive and is typically a same‒day procedure. Most cases take one to two hours, followed by a few hours of recovery observation. Patients who are doing well can usually return home the same day and resume normal activities within about a week.

Don’t Delay Care

When it comes to heart health, timing matters. Ongoing palpitations, a racing heart, dizziness, or fainting should prompt a call to your doctor. Symptoms of heart attack such as chest or back pain, shortness of breath, or arm tingling require immediate medical attention. Call 911 right away.

Even subtle symptoms can have serious consequences if ignored. Paying attention to warning signs and seeking care early can make a lifesaving difference.

— — — —

Suppiramaniam Sreeharikesan, M.D., is an electrophysiologist with UPMC Heart and Vascular Institute and sees patients at 740 High St., Suite 2001, Williamsport.

To schedule an appointment, call 570-321-2800. To learn more about the experts and services available for diagnosis and treatment in northcentral Pennsylvania, visit UPMC.com/HeartNCPA.