Many people have irregular heartbeats, and many people have hypertension. It is important to be able to measure blood pressure accurately in the presence of an irregular heartbeat.

The heart contains it own pacemaker. There are specialized cells in the heart that determine the number of heartbeats per minute that the heart will make. The net result of a heartbeat is that the chambers of the heart contract in a synchronous fashion, and blood is pumped throughout the circulation. The heartbeat is easily detected by feeling an individual’s pulse in the wrist or in the neck, or by listening to the front of the chest with a stethoscope. Normal hearts beat at a rate of between 60-90 beats per minute, and the beats are regular. This means that there is a uniform period of time between each heartbeat. A disorder of the heart rate, or of the interval between heartbeats is called an arrhythmia. A disorder of the heart rate is either a bradyarrhythmia, which means the heart beats too slowly, or a tachyarrhythmia, which means the heart beats too rapidly. If the interval between heartbeats is altered, then this is called an irregular heartbeat. Other descriptive terms for irregular heartbeats include extra beats, extra systoles, premature beats or premature contractions. An individual may become aware of irregular heartbeats and have a sensation of palpitations or fluttering in the chest. Normal persons may have irregular heartbeats occasionally. Certain medications or foods (caffeine, alcohol) may increase the frequency of irregular heartbeats.

There are several heart disorders that are characterized by irregular heartbeats. One of the most common is called atrial fibrillation. In this disorder, the pacemaker of the heart is not functioning normally and instead of a regular heartbeat, the heartbeat is irregular. In other words, there is a variable interval, instead of a fixed interval between heartbeats. This condition may be due to coronary artery disease, overactive thyroid, or there may be no detectable cause. Individuals with high blood pressure are more likely to have this condition. This condition is often not associated with serious consequences, however it does require treatment. The first treatment may be directed to changing the heart rate back to a normal regular beat, so called normal sinus rhythm. This is usually only attempted if an individual has not had the condition for very long, since the longer atrial fibrillation is present the less amenable to conversion to normal sinus rhythm. Another aspect of treatment is to control the rate – in other words keep the rate in the target range of 60-90 bpm. Finally, blood thinners are sometimes recommended for this condition, since an irregular heart beat may lead to blood clots in the heart, which then may lead to a stroke.