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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest remedies for heart palpitations

Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 7004 Questions

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Posted on Mon, 6 Jun 2016 in Hypertension and Heart Disease
Question: I have been having runs of palpitations. I am so symptomatic that I cannot do my job or conduct my normal activities. My life style has definitely been impacted negatively. I have had echo & stress cardiograms & I know I am dubutemine sesitive. An EP at the XXXXXXX clinic had suggested an ablation but now she appears to be wavering on that . I have severe sleep apnea so was told to get off of Effexor. I have reduced my Effexor but can't seem to get off it completely without having severe palpitations. I have also been told to get off Flecainide because I am only 41 years old. I was adopted so I do not have a family medical history. My EP does not want to do anything until I have more severe symptoms but I am very frustrated and not able to function well. she has refused to order a long term monitor because previsou monitors have not shown the severity of problems she wants to see. Visits to the ER have not been useful as my palpitations are intermittent. At this point I am taking about 16 mg of Effexor, 25 mg of Atenol 2 x daily, Flecainide 100 mg, Klonopin 1.5 mg 2 x daily. What do I do to relieve my palpitations?
doctor
Answered by Dr. Ilir Sharka 59 minutes later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome back on HCM!

I carefully passed through your question and would like to explain that when dealing with a cardiac arrhythmia it is very important:

1. First to properly classify whether it is just an extra-systolic arrhythmia or a more complex one.
2. Also it is important to appropriately quantify the amount of arrhythmia.

If the above two criteria conclude about an important cardiac arrhythmia, then it is advisable to further investigate a possible arrhythmogenic substrate.

On this regard, certain cardiac tests are helpful, such as:

- cardiac MRI (identifying possible causes)
- invasive electrophysiological studies (EPS), identifying the possible arrhythmogenic focus.

For a more concrete opinion, I would like to review any available arrhythmia recordings.

Please, could you upload them?

Regarding your concrete question, I would explain that there are several anti-arrhythmic drugs that could be helpful in minimizing your arrhythmic events. But first, it is necessary to properly classify your arrhythmia (like I explained you above).

What is more important in your case and that I think you should especially consider dealing with is to optimize your sleep apnea therapeutic strategies.

You should know that sleep apnea is a very important factor for triggering cardiac arrhythmia.

It may also exacerbate a preexisting cardiac arrhythmia.

If sleep apnea is properly treated, probably your heart palpitations could be completely controlled.

On this purpose, I would recommend performing a polysomnography and an arterial blood gas analysis and discussing on these issues with a sleep apnea specialist or a pulmonologist.

Ventilation assisting devices (CPAP, BPAP,etc.) are helpful for treating this issue.

Hope to have been have been helpful!

Feel free to ask any other questions whenever you need to!

Best wishes,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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