Heart Palpitations Cardiologist in New Jersey
Comprehensive evaluation of heart palpitations, skipped beats, and arrhythmias by board-certified FACC cardiologists — expert diagnosis with in-office cardiac monitoring at Cross County Cardiology.
Heart palpitations evaluation at Cross County Cardiology, NJ
What Are Heart Palpitations?
Heart palpitations are sensations of a racing, fluttering, pounding, or irregular heartbeat. They may be felt in the chest, throat, or neck. Palpitations are extremely common and are often benign — triggered by caffeine, stress, dehydration, or lack of sleep. However, palpitations can also be a symptom of a cardiac arrhythmia, including atrial fibrillation, supraventricular tachycardia (SVT), ventricular premature contractions (VPCs), or ventricular tachycardia. Accurate diagnosis requires cardiac monitoring to capture the heart rhythm during symptoms.
Common Causes of Heart Palpitations
Premature Atrial Contractions (PACs) and Premature Ventricular Contractions (PVCs) — Extra heartbeats originating in the atria or ventricles are the most common cause of palpitations. They are usually benign and often described as a “skipped beat” or a flip-flop sensation in the chest. Frequent PVCs (more than 10,000 per day) may require treatment.
Atrial Fibrillation (AFib) — The most common sustained cardiac arrhythmia. AFib causes an irregular, often rapid heartbeat and carries risk of stroke. Palpitations are the most common presenting symptom, though AFib may also be silent.
Supraventricular Tachycardia (SVT) — A family of arrhythmias originating above the ventricles that cause episodes of sudden-onset rapid heart rate (typically 150–250 bpm). SVT episodes may last seconds to hours and often terminate spontaneously. AVNRT (AV nodal reentrant tachycardia) is the most common form.
Ventricular Tachycardia (VT) — A potentially dangerous arrhythmia originating in the ventricles. Palpitations associated with lightheadedness, near-fainting, or loss of consciousness require urgent evaluation to rule out VT.
When Should Palpitations Be Evaluated Urgently?
Seek immediate medical attention if palpitations are accompanied by chest pain or pressure, shortness of breath, lightheadedness, near-syncope (near-fainting), or actual loss of consciousness. Palpitations with these associated symptoms may indicate a serious arrhythmia requiring prompt cardiac evaluation or emergency care. Any new palpitations in a patient with known heart disease or a prior cardiac event also warrant urgent assessment.
How We Evaluate Palpitations
Our cardiac evaluation for palpitations begins with a 12-lead electrocardiogram (EKG) and resting echocardiogram to assess heart structure and baseline rhythm. Since palpitations are often intermittent, ambulatory cardiac monitoring is critical for diagnosis. We offer Holter monitors (24–48 hour continuous recording) and extended event monitors (up to 30 days) to capture arrhythmias during daily activity. For patients with infrequent but significant episodes, an implantable loop recorder (ILR) may be recommended for continuous monitoring over 1–3 years. Thyroid function tests and electrolyte levels are checked to identify reversible metabolic causes.
Treatment Options for Heart Palpitations
Treatment depends entirely on the underlying cause. Lifestyle modifications — reducing caffeine, improving sleep, managing stress, and avoiding stimulants — often resolve benign palpitations. For atrial fibrillation, rate control, rhythm control, and anticoagulation are the pillars of management. SVT may be treated with vagal maneuvers, antiarrhythmic medications, or catheter ablation — a minimally invasive procedure with high cure rates. Frequent symptomatic PVCs may be treated with beta-blockers, calcium channel blockers, or ablation. Ventricular arrhythmias associated with structural heart disease require specialized electrophysiology evaluation and may require an implantable defibrillator (ICD).
Why Choose Cross County Cardiology?
- Board-Certified, FACC Cardiologists — Fellowship of the American College of Cardiology credentialed physicians
- Affiliated with Mount Sinai & Hackensack Meridian Health — Academic medical center connectivity for complex referrals
- 5 NJ Locations — Secaucus, Edgewater, Teaneck, Hoboken, and North Bergen
- Same-Week Appointments Available — Fast access without long waits
- Comprehensive In-Office Cardiac Monitoring — Holter monitors, event recorders, EKG, and echocardiography on-site
Frequently Asked Questions
Are heart palpitations dangerous?
Most palpitations are benign — caused by PACs, PVCs, or non-cardiac triggers like caffeine, anxiety, or dehydration. However, palpitations associated with dizziness, fainting, chest pain, or shortness of breath can indicate a serious arrhythmia and require prompt evaluation. The only way to determine if palpitations are dangerous is to capture the heart rhythm during an episode with cardiac monitoring.
What is a Holter monitor?
A Holter monitor is a portable EKG device worn continuously for 24–48 hours that records the heart’s electrical activity during normal daily activities. It is the standard first-line tool for diagnosing palpitations and arrhythmias. If symptoms are infrequent, longer-term event monitors or implantable loop recorders (worn for up to 3 years) may be recommended.
Can stress cause heart palpitations?
Yes. Psychological stress and anxiety trigger the release of adrenaline (epinephrine), which increases heart rate and can provoke palpitations, PACs, or PVCs. However, because stress-related and arrhythmia-related palpitations can feel identical, a cardiac evaluation is appropriate for any new or concerning palpitations — especially in patients with risk factors for heart disease.
What is SVT and how is it treated?
Supraventricular tachycardia (SVT) is a family of arrhythmias causing sudden-onset rapid heart rate. Episodes typically start and stop abruptly. Vagal maneuvers (bearing down, cold water on the face) may terminate episodes. Medications such as adenosine, beta-blockers, or calcium channel blockers provide acute and preventive treatment. Catheter ablation is curative in more than 90% of cases and is often preferred over long-term medication for patients with recurrent SVT.
Do palpitations mean I have atrial fibrillation?
Palpitations are the most common symptom of atrial fibrillation (AFib), but the majority of patients with palpitations do not have AFib. PACs, PVCs, and SVT are far more common causes of palpitations than AFib. Diagnosis requires an EKG or ambulatory monitor that captures the rhythm during symptoms. If AFib is found, further evaluation — including echocardiogram and stroke risk assessment — is performed.
