The Effect of Proton Pump Inhibition on Palpitations
The Effect of Proton Pump Inhibition on Palpitations
Feeling of palpitations with no clear arrhythmia is frequently encountered in clinical
 practice. The majority of these patients have documented sinus rhythm even while having
 symptoms. Gastrointestinal association with such symptoms was first described by Ludwig von
 Roemheld (1871-1938).The investigators thought to investigate the effect of proton pump
 inhibition in patients with feeling of palpitations but no clear cause.
One hundred and fifty patients with palpitations and no clear cause for their symptoms will
 be randomized to receive either proton pump inhibitor (PPI) (lanzoprazole 30 mg) or placebo
 for one month. At base line they will be investigated to rule out arrhythmia by documenting
 normal heart rate (less than 110 beat per minute) or ECG showing normal sinus rhythm or mild
 sinus tachycardia (Less than 110 per minute) during symptoms. Obvious causes such as anxiety
 due to a stressful event or organic causes such anemia or thyroid disorders should be also
 ruled out.

 Patient who agree to participate in the study will be asked to sign an informed consent. A
 baseline questionnaire with symptoms will be filled. They will then be randomized for
 treatment with either PPI or placebo once at night time. After 10 days of treatment they will
 be contacted and questioned regarding their symptoms. The two groups will be compared to see
 if there is any improvement of symptoms with treatment.
Inclusion Criteria:

 1. Persons with palpitations and no clear cause who are above the age of 16 years and who
 consent to the study will be included

 2. Clear causes that should be excluded are true arrhythmia such SVT or VT or frequent
 premature atrial or ventricular contractions or any organic cause such as thyroid
 disorder, anemia (hg less than 11 g/dl) and obvious anxiety disorder

 3. Arrhythmia can be excluded by an ECG showing sinus rhythm or sinus tachycardia during
 episodes or measurement of heart rate by a reliable method during symptoms showing
 regular heart rate less than 120 beats per minute.

 Exclusion Criteria:

 1. Refusal to sign consent form

 2. Already taking PPI or H2 blocker

 3. Frequency of symptoms less than 2 times per week