How can I tell if it is dangerous?

If a heart stumble occurs occasionally under stress, there is usually no reason to worry. Heart flutter occurs very frequently in young, heart-healthy people. If heart flutter occurs frequently, it can be useful to write an ECG to record the heart action.

Often, however, extrasystoles occur so rarely that they are not recorded for the duration of an ECG, namely about 10 seconds. In this case it may be useful to record a 24-hour ECG. However, even in this period of time, not all patients with occasional heart stumbles are detected.

However, a 24-hour ECG can provide initial indications of whether structural and functional disorders of the heart are present. If the heart stumbling occurs mainly during sporting activity, it is advisable to perform a so-called exercise ECG. This refers to an ECG that is recorded during physical exertion, usually during exercise on a bicycle ergometer. An ultrasound examination of the heart (echocardiography) can also be performed. If necessary, a blood test is also performed to check electrolytes and thyroid gland values.

The treatment

If heart stumbling in the sense of extrasystoles occurs in heart-healthy patients during exercise, no therapy is usually required. Exceptions are diseases that are the cause of the triggering of extrasystoles, such as hyperthyroidism. As a rule, this must be treated with medication.

However, this is not so much because of the heart stumbling but because of other potentially serious symptoms. Even if deviations from the electrolyte balance in the blood are the cause, they may require treatment. Depending on which electrolytes have derailed, infusions, electrolyte substitutions or medication may be necessary.

If structural heart disease is the cause of the heart stumble, it must be treated specifically. If coronary heart disease (CHD) is present, for example, the implantation of stents may be necessary to keep narrowed coronary vessels sufficiently open.In addition, if coronary heart disease is present, certain medications must be taken permanently, such as fat reducers like simvastatin and blood thinners. If the heart stumbles very frequently during sport and causes symptoms, taking beta blockers can – theoretically – be helpful.

The disadvantage of beta-blockers, however, is that they dampen the heart’s action. This means that the heart rate can no longer increase sufficiently during higher physical exertion. This is counterproductive in certain sports.

Therefore, the use of beta blockers should be weighed up very carefully. In the case of a disturbing heart stumbling, it is therefore advisable to first try non-prescription drugs such as dietary supplements containing potassium and magnesium. There are numerous different preparations available without prescription from pharmacies or drugstores.

They can stabilize the threshold at the heart and thus lead to a reduction of heart stumbles. Tromcardin® is mentioned as an example. If the drug therapy does not have a sufficient effect, a so-called catheter ablation can be considered for patients with strongly symptomatic extrasystoles. In this procedure, a catheter inserted through the groin vein is used to locate the source of the extrasystoles in the heart and sclerose it.