What causes heart palpitations and what do you do about it? i have had a problem for many years with heart palpitations. i know that caffeine is a real culprit and i try to stay away from it as much as i can. what else can i do?

A : A variety of abnormal heart rhythms, or arrhythmias, can cause palpitations. Most causes are not dangerous, and the most common are premature atrial or ventricular contractions (pacs and pvcs). This is when there is an extra beat from the upper or lower chamber of the heart, which can be sensed as an extra beat or a skipped beat. But often times people cannot feel them at all. There are a whole variety of other arrhythmias though, and many require specific treatment by a cardiologist. If you have had palpitations for years, they are most likely not serious but you should be evaluated if you have not already done so. It would be important for your doctor to exclude potentially dangerous things. If you know caffeine is a trigger for your palpitations, then avoiding it is the right thing to do. Other common triggers are alcohol, dehydration, and fatigue. If your palpitations are frequent and bothersome, your doctor may be able to prescribe a medication to help minimize them. Of course, this requires an accurate diagnosis first.

Lots of Things: If it's just a single out of place beat here or there, it's just an irritable extra beat from either the top or bottom chambers. If it's a sustained thing with a fast run, it's usu one of 3 different rhythms we collectively call svts. If it's all the time, it could be inappropriate sinus tach, atrial flutter or atrial fib. A cardiac electrophysiologist can help you get to the bottom of this.