Irregular heartbeat (cardiac arrhythmia)

For a lay person:

A cardiac arrhythmia is a heartbeat that is too fast, too slow or irregular. Many are harmless, such as occasional extra beats, but some, such as atrial fibrillation or ventricular arrhythmias, can lead to stroke, heart failure or collapse. They are more common with age, heart disease, thyroid problems, alcohol and stimulants.

For a trained medical person:

Arrhythmias arise from abnormal automaticity, triggered activity or re-entry, and include ectopic beats, atrial fibrillation and flutter, supraventricular and ventricular tachycardias, and bradyarrhythmias. Diagnosis is by ECG, ambulatory or event monitoring, with echocardiography and thyroid and electrolyte tests to find causes. Management depends on type and includes treating triggers, rate or rhythm control drugs, anticoagulation for atrial fibrillation according to stroke risk, catheter ablation and devices such as pacemakers or defibrillators.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Heart Yang Deficiency, Yang Deficiency, and Yin Excess; Spleen, Heart, and Kidney All-Deficient; Heart Qi Deficiency, Upward Flowing of Turbid Phlegm; Heart Yin Deficiency, Heart and Kidney Disharmony; Qi and Yin Deficiency, Qi Stagnation, and Blood Stasis; Spleen and Heart Deficiency, Qi Deficiency and Blood Stasis Syndr ome; Gallbladder Qi Deficiency and Timidity, and Phlegm Heat Upward Disturbing; Insufficient True Yin, and Heart Yin Exhaustion; Qi and Blood Deficiency; Phlegm and Damp Disturbing the Heart; Qi and Yin Deficiency; Heart and Kidney Yang Deficiency. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: Get emergency care for palpitations with chest pain, fainting, severe breathlessness or signs of stroke. Herbs can interact with anticoagulants and antiarrhythmic drugs, and stimulant herbs such as ephedra (Ma Huang) or aconite-containing products can trigger dangerous rhythms.