Heart palpitations are sensations of your heartbeat that feel uncomfortable or unusual, often described as racing, pounding, fluttering, or skipping beats. While these episodes can feel alarming, most people can manage them effectively through simple changes in daily habits, stress reduction techniques, and in some cases, medical treatment when an underlying heart condition is identified.

Understanding Your Options for Managing Heart Palpitations

When you experience heart palpitations, your main goal is to find relief and ensure your heart is healthy. The approach to managing these sensations depends heavily on what causes them and whether they indicate a serious heart problem or simply reflect normal variations in heart rhythm that many people experience throughout their lives.^[1]

Most treatment strategies focus on identifying and removing triggers, managing anxiety and stress, and addressing any underlying medical conditions that might be contributing to your symptoms. For many people, palpitations occur without any serious underlying cause and can be managed without prescription medications or invasive procedures.^[2]

Your doctor will first need to determine whether your palpitations stem from a heart rhythm problem, another medical condition, or lifestyle factors. This assessment guides the entire treatment plan. Some people need only lifestyle adjustments, while others may require medications or procedures to correct abnormal heart rhythms.^[3]

The treatment journey often begins with simple steps you can take at home, but it’s important to understand when medical intervention becomes necessary. Your healthcare provider will help you understand which approach is right for your specific situation based on your symptoms, medical history, and test results.^[4]

Standard Treatment Approaches

Lifestyle Modifications as First-Line Treatment

For most people with heart palpitations, the first and often most effective treatment involves making changes to daily habits and routines. These modifications aim to reduce or eliminate common triggers that can make your heart beat faster or more noticeably.^[5]

Reducing or eliminating stimulants is one of the most important steps. Caffeine, found in coffee, tea, energy drinks, and chocolate, can trigger palpitations in many people. Similarly, nicotine from tobacco products and alcohol consumption are known triggers. Your doctor may recommend gradually reducing your intake of these substances to see if your symptoms improve.^[6]

Stress management plays a crucial role in controlling palpitations. When you feel anxious or stressed, your body releases adrenaline, a hormone that makes your heart beat faster and harder. This is your body’s natural fight-or-flight response. Learning to manage stress through techniques like meditation, deep breathing exercises, yoga, or regular physical activity can significantly reduce the frequency and intensity of palpitations.^[12]

Maintaining good overall health habits supports heart rhythm stability. Getting adequate sleep, staying well-hydrated, and eating a balanced diet rich in nutrients helps your heart function properly. Dehydration and low levels of important minerals called electrolytes (including potassium, magnesium, and calcium) can trigger palpitations. Eating fruits, vegetables, and whole foods helps maintain proper electrolyte balance in your body.^[12]

Certain medications you might take for other conditions can cause palpitations as a side effect. These include some asthma inhalers, decongestants found in cold medicines, thyroid medications, and drugs used to treat high blood pressure. You should never stop taking prescribed medications without consulting your doctor, but they can review your medications and potentially adjust them if they’re contributing to your symptoms.^[1]

Medical Treatments When Lifestyle Changes Aren’t Enough

When palpitations are caused by an underlying heart rhythm problem called an arrhythmia, your doctor may recommend specific medical treatments. The type of treatment depends on which arrhythmia you have and how severe it is.^[8]

Medications can help control heart rate and rhythm. Beta-blockers are a class of drugs that slow down the heart rate and reduce the force of heart contractions. While these medications are commonly used for high blood pressure and heart disease, they can also help manage palpitations caused by certain arrhythmias. However, interestingly, beta-blockers themselves can sometimes cause palpitations as a side effect in some people.^[1]

Antiarrhythmic medicines are specialized drugs designed to maintain normal heart rhythm. These medications work by affecting the electrical signals in your heart that control its beating pattern. Your doctor carefully selects and monitors these medications because they must be tailored to your specific type of arrhythmia.^[1]

For some people with frequent palpitations caused by premature contractions (extra heartbeats that occur earlier than normal), treatment may not be necessary if the heart is otherwise healthy. Many people have these extra beats without any increased health risks. Your doctor will evaluate your overall heart health to determine if treatment is needed.^[14]

Treatment of underlying medical conditions is essential when palpitations result from other health problems. An overactive thyroid (hyperthyroidism) causes the body’s metabolism to speed up, which can trigger palpitations. Treating the thyroid condition with medication often resolves the palpitations. Similarly, treating anemia (low red blood cell count) with iron supplements or other therapies can eliminate palpitations caused by the heart working harder to deliver oxygen to your body.^[1]

Procedures for Specific Heart Rhythm Problems

Some people with palpitations caused by specific types of arrhythmias may benefit from procedures that correct the abnormal heart rhythm. These are typically considered when medications don’t adequately control symptoms or when certain types of dangerous arrhythmias are identified.^[8]

Catheter ablation is a procedure where doctors thread thin tubes called catheters through blood vessels to reach your heart. They use energy (either heat or cold) to destroy tiny areas of heart tissue that are causing abnormal electrical signals. This procedure can cure certain types of arrhythmias, particularly supraventricular tachycardia (a rapid heart rhythm that starts in the upper chambers of the heart).^[11]

For people with slow heart rhythms caused by problems with the heart’s natural pacemaker, an artificial pacemaker device may be implanted under the skin. This small device sends electrical signals to keep the heart beating at a normal rate. Similarly, for people at risk of dangerous fast heart rhythms, an implantable cardioverter defibrillator (ICD) can be placed to detect and correct life-threatening arrhythmias.^[8]

Diagnostic Testing to Guide Treatment

Before starting any treatment, your doctor needs to understand what’s causing your palpitations. A standard electrocardiogram (ECG or EKG) is usually the first test performed. This quick, painless test measures your heart’s electrical activity by placing sticky patches on your chest. It can detect abnormal heart rhythms if they occur during the brief time you’re hooked up to the machine.^[8]

Because palpitations often come and go unpredictably, your doctor may recommend wearing a portable heart monitor that records your heart rhythm over time. A Holter monitor is worn for 24 to 48 hours and continuously records your heart rhythm during your daily activities. This is helpful if you experience palpitations daily.^[8]

For palpitations that occur less frequently, an event recorder might be more appropriate. You wear this device for several weeks or even months, and you press a button when you feel symptoms. The device records what your heart was doing at that moment. Some modern smartwatches can also perform remote ECG monitoring, which your doctor might suggest as an option.^[8]

An echocardiogram uses sound waves to create moving pictures of your heart. This test helps your doctor see the structure of your heart and how well it’s pumping blood. It can identify problems with heart valves or other structural issues that might cause palpitations.^[8]

Your doctor may also check for non-heart-related causes of palpitations through blood tests. These can detect thyroid problems, anemia, low blood sugar, or electrolyte imbalances that might be triggering your symptoms.^[7]

Self-Help Techniques During Episodes

When you feel palpitations starting, there are several techniques you can try to help restore normal heart rhythm. These are called vagal maneuvers because they stimulate the vagus nerve, which connects your brain to your heart and can help slow down a rapid heartbeat.^[12]

The Valsalva maneuver involves holding your breath and bearing down as if you’re having a bowel movement. This creates pressure changes in your body that can help reset your heart rhythm. Other techniques include coughing, splashing cold water on your face, or applying an ice pack to your face for a few seconds. Some people find that chanting “Om” or taking slow, deep breaths helps calm their heart rate.^[12]

If you start feeling dizzy or lightheaded during palpitations, sit or lie down immediately to prevent injuries from falling. Taking deep breaths and trying to remain calm can also help, as anxiety about the palpitations can make them worse.^[19]

Your doctor might teach you specific techniques that work best for your type of palpitations. It’s helpful to keep a record of when palpitations occur, what you were doing when they started, how long they lasted, and what helped them stop. This information assists your doctor in understanding your condition and adjusting your treatment plan.^[19]

Research into New Treatment Approaches

While most palpitations are managed successfully with existing treatments, researchers continue studying new approaches to better understand and treat heart rhythm problems. Currently, there is limited information available about specific experimental therapies being tested in clinical trials specifically for palpitations themselves, as treatment typically focuses on the underlying causes such as specific arrhythmias.

Research into arrhythmias continues to advance our understanding of how the heart’s electrical system works and how to correct problems when they occur. Scientists are studying new medications, improved catheter ablation techniques, and better devices for monitoring and treating heart rhythm disorders.

For people with anxiety-related palpitations, researchers are exploring the effectiveness of various psychological interventions and stress management programs. Understanding the connection between mental health and heart rhythm helps doctors develop more comprehensive treatment approaches that address both the physical and emotional aspects of palpitations.^[14]

Most Common Treatment Methods

• Lifestyle Changes
  • Reducing or eliminating caffeine, alcohol, and nicotine intake to avoid common triggers
  • Managing stress through meditation, yoga, deep breathing exercises, and regular physical activity
  • Getting adequate sleep and maintaining regular sleep schedules
  • Staying well-hydrated and eating a balanced diet rich in electrolytes
  • Avoiding or carefully managing medications that may trigger palpitations
• Medical Management
  • Beta-blocker medications to slow heart rate and reduce force of contractions
  • Antiarrhythmic medications to maintain normal heart rhythm
  • Treatment of underlying conditions such as thyroid disorders, anemia, or electrolyte imbalances
  • Medication review and adjustment to eliminate drugs causing palpitations as side effects
• Vagal Maneuvers
  • Valsalva maneuver (bearing down as if having a bowel movement)
  • Applying ice or cold water to the face
  • Coughing or deep breathing techniques
  • Other physical maneuvers that stimulate the vagus nerve to slow heart rate
• Procedures for Arrhythmias
  • Catheter ablation to destroy tissue causing abnormal electrical signals
  • Pacemaker implantation for slow heart rhythms
  • Implantable cardioverter defibrillator (ICD) for dangerous fast rhythms
• Diagnostic Testing
  • Electrocardiogram (ECG/EKG) to detect abnormal heart rhythms
  • Holter monitoring for 24-48 hours of continuous heart rhythm recording
  • Event recorders for longer-term monitoring of intermittent palpitations
  • Echocardiogram to assess heart structure and function
  • Blood tests to identify underlying medical conditions
• Stress and Anxiety Management
  • Counseling or therapy for anxiety and panic disorders
  • Relaxation techniques including guided imagery
  • Regular exercise programs tailored to individual capabilities
  • Support groups for people living with heart rhythm concerns