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Dr. Roach: I am 82 years old and still very active. I have had an irregular heartbeat for four years, and sometimes I feel lightheaded, dizzy or tired. I worry about it getting worse. Would you please give a detailed explanation about irregular heartbeat, including how or why it happens? What I should do to prevent it from getting worse? Is it life threatening? Will it become atrial fibrillation?

Also, I am a chocolate lover and eat dark chocolate every day. But I was told that cocoa will make my irregular heartbeat worse and I should stop eating dark chocolate. Is that true?

Q.Y.

Dear Q.Y.: Everyone has irregular heartbeats from time to time. Early beats can come from electrically active areas anywhere in the heart, and an electrocardiogram can tell whether they are from the atria (the top chambers) or the ventricles (the bottom chambers) of the heart.

An average person may have 500 or so of these a day — some people have many more. Most are seldom aware of them. Having patients with this concern over and over during my career, I can reassure you that most cases turn out to be nothing to worry about.

However, the fact that you are having symptoms, especially the lightheadedness and fatigue, is a warning sign, and I recommend you get an evaluation. Start with your regular medical provider, after which you may be referred to a cardiologist. The EKG in his or her office is a first step, but you may need a longer evaluation, such as wearing a 24-hour EKG (a Holter monitor) or newer technologies that allow longer readings.

Atrial fibrillation is a concern, because most people will need treatment to reduce stroke risk or to return the rhythm to normal. Nevertheless, there are many other kinds of irregular heart rhythms, and you need a diagnosis first. If no cause is found, there are medications to reduce the irregularity, but they are seldom used. My experience is that when a person knows they are not dangerous, they can be lived with more easily.

Chocolate does contain theobromide, a substance that can make the heart a little more irritable, but it takes a lot of chocolate to have a significant effect. It’s related to caffeine in coffee. Interestingly, a recent study found that chocolate lovers are less likely to develop atrial fibrillation, so the situation is more complex than just one chemical.

Dear Dr. Roach: What do you think of “grounding” or “earthing”? I have read testimonials as to how beneficial and easy it is to reconnect to the earth. Is there anything to this?

P.G.

Dear P.G.: I think reconnecting to the earth is a great idea. Being out in nature is a good thing, and I think that being barefoot (when safe) can bring about a sense of well-being and a sense of freedom. However, claims about healing arthritis (and other chronic medical issues) due to electron transfer from the earth are not substantiated and highly improbable, and all of the purported benefits can be explained by a placebo response.

All that being said, I am a proponent of the placebo response. If you feel that walking barefoot is making you feel better or helping your symptoms, please do so (carefully). I would caution you strongly against spending money on devices that are supposed to help you through “grounding.”

Email questions to ToYourGoodHealth@med.cornell.edu

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