Harvard Heart Letter

Ask the doctor: Why does my heart sometimes feel like it stops, then starts up again with a jerk?

Q. I am 92 years old. I have atrial fibrillation and high blood pressure, both controlled by medication. Every so often when I am relaxed in my chair after dinner, my heart feels like it stops and then starts up again with a jerk. Is this something I should worry about?

A. If you have atrial fibrillation, it is common to feel your heart pause and then start up with a bit of a kick. Here's why:

In atrial fibrillation, the top parts of the heart (the atria) are beating erratically and very fast — much faster than the usual once-a-second of the normal heartbeat. Fortunately, a tollbooth called the atrioventricular (AV) node sits between the top and bottom chambers (the ventricles) of the heart. The AV node filters out some of the beats from the upper chambers. This allows the bottom chambers to pump blood at a more normal rate. The AV node is one reason why atrial fibrillation is not as serious as a rhythm problem in the ventricles.

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