Heart palpitations and arrhythmia treatment in Gaithersburg and Columbia, Maryland

Heart Palpitations & Arrhythmia Treatment

Heart palpitations—the sensation of a racing, fluttering, skipping, or pounding heartbeat—can be alarming and disruptive to your daily life. At Capital Cardiac Care, our cardiologists, Dr. Pankaj Lal and Dr. Kunal Lal, specialize in diagnosing and treating arrhythmias (irregular heartbeats) that cause these uncomfortable sensations.

While some palpitations are benign, others indicate underlying heart conditions requiring treatment. Our comprehensive evaluation and expert management help you understand what’s happening with your heart and restore your sense of well-being.

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Understanding Heart Palpitations and Arrhythmias

Palpitations are the conscious awareness of your heartbeat—normally you don’t notice your heart beating, but with palpitations you feel it clearly. Arrhythmias are irregular heartbeats that can be rapid (tachycardia), slow (bradycardia), or irregularly timed.

Common arrhythmias include:

  • Atrial Fibrillation (AFib) – rapid, irregular atrial contractions increasing stroke risk
  • Atrial Flutter – rapid regular atrial contractions
  • Premature Ventricular Contractions (PVCs) – extra beats from the heart’s lower chambers
  • Supraventricular Tachycardia (SVT) – suddenly rapid heart rate originating above the ventricles
  • Bradycardia – abnormally slow heart rate
  • Heart Blocks – electrical signals slow or fail to pass through the heart

Palpitations may result from coronary artery disease, heart failure, high blood pressure, thyroid disease, caffeine, stress, dehydration, or medication side effects.

Symptoms of Arrhythmias

While some arrhythmias cause no symptoms, others produce:

Symptoms depend on the specific arrhythmia type, heart rate, and how long the abnormality lasts.

Diagnosis of Arrhythmias

We use several diagnostic tools to identify arrhythmias:

  • Electrocardiogram (EKG) captures the heart’s electrical activity and reveals many arrhythmias
  • Holter Monitor or Event Recorder tracks your heart rhythm over 24-48 hours or longer to catch intermittent arrhythmias
  • Echocardiography visualizes heart structure and function
  • Stress Testing reproduces arrhythmias during exertion
  • Blood Tests check thyroid function and electrolytes
  • Electrophysiology Study (EPS) maps electrical pathways when surgical intervention may be needed

Treatment Options for Arrhythmias

Treatment depends on the specific arrhythmia, your symptoms, and underlying heart disease.

  • Lifestyle Modifications: Reducing caffeine, managing stress, staying hydrated, treating sleep disorders, and managing high blood pressure often improve palpitations
  • Medications: Beta-blockers, calcium channel blockers, antiarrhythmic drugs, and anticoagulants (for AFib) may control arrhythmias and reduce symptoms
  • Cardioversion: Electrical cardioversion resets abnormal heart rhythms to normal
  • Ablation Therapy: Radiofrequency or cryoablation destroys tissue causing arrhythmias, useful for SVT, AFib, and other conditions
  • Device Therapy: Pacemakers manage slow rhythms; implantable cardioverter-defibrillators (ICDs) treat life-threatening arrhythmias

Living with Arrhythmias

Many arrhythmias are successfully managed with appropriate treatment. Regular monitoring allows us to track your rhythm, assess medication effectiveness, and adjust treatment as needed. Most patients with controlled arrhythmias live normal, active lives.

What causes heart palpitations?

Palpitations can result from arrhythmias, coronary artery disease, heart failure, valve disease, fever, infection, thyroid problems, anemia, dehydration, caffeine, alcohol, stimulant medications, cocaine use, anxiety, stress, or intense exercise. Often palpitations are benign (like occasional PVCs), but a cardiologist should evaluate them to rule out serious conditions.

Are palpitations dangerous?

Not all palpitations indicate serious disease. Occasional palpitations from caffeine or stress are usually harmless. However, some arrhythmias—particularly atrial fibrillation or rapid ventricular rates—can be dangerous, causing shortness of breath, chest pain, syncope, or increasing stroke and heart failure risk. Seek immediate care if palpitations accompany chest pain, severe shortness of breath, fainting, or last more than a few minutes.

How are arrhythmias diagnosed?

An EKG is the first test, capturing electrical activity during the recording. If your EKG is normal but symptoms persist, we use Holter monitors or event recorders worn for days or weeks to catch intermittent arrhythmias. Echocardiograms assess heart structure, and blood tests check thyroid and electrolytes. Sometimes an electrophysiology study is needed to map electrical pathways precisely.

What is atrial fibrillation?

Atrial fibrillation (AFib) is the most common arrhythmia, involving rapid, chaotic atrial contractions creating an irregular ventricular rhythm. It causes palpitations and increases stroke risk because irregular contractions allow blood to pool and clot. AFib is managed with rate-control medications, anticoagulants (blood thinners) to prevent stroke, and sometimes rhythm-control drugs or ablation therapy. Regular monitoring is essential.

Do I need medication for palpitations?

Not necessarily. Some palpitations from anxiety, caffeine, or stress resolve with lifestyle changes. However, if your arrhythmia causes symptoms, increases heart disease risk, or affects heart function, medications or other treatments are recommended. Your cardiologist will discuss whether treatment is appropriate for your specific arrhythmia.

What is an ablation procedure?

Ablation uses radiofrequency energy or extreme cold to destroy small areas of heart tissue causing abnormal electrical signals. It’s performed during an electrophysiology study and is curative for many arrhythmias like SVT and some AFib cases. Success rates are high, and most patients experience significant symptom improvement or elimination. Recovery is typically quick with minimal downtime.

Can anxiety cause palpitations?

Yes, anxiety and panic disorder commonly cause palpitations. Anxiety triggers adrenaline release, increasing heart rate and causing awareness of your heartbeat. However, some people with anxiety also have underlying arrhythmias. If palpitations are new or persistent, have a cardiologist evaluate them to distinguish anxiety-related palpitations from true arrhythmias. Managing anxiety through counseling, exercise, and stress reduction helps reduce palpitations.

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