<s>[INST] heart palpsI am getting flutters in my chest/throat area and have done for 6 hrs now. they feel a lot like heart palpitations. I was previously investigated for these a yr ago and nothing untoward showed up. I Am on a low dose of bisoprolol for it. should I be worried that they're back. I really don't think I could go through it again [/INST] Hello. Thank you for your question and welcome to HCM. I understand your concern. If I am assuming right, this a paroxysm of a supraventricular arrhythmia (atrial tachycardia, atrial fibrillation, atrial flutter). I would recommend as a first thing to do to be put on a 24-hour Holter rhythm monitor, or an episode rhythm monitor, which you will turn on when you have these symptoms again. Anyway, bisoprolol is a beta-blocker with a good effect on high blood pressure, bot not a significant effect on heart rate. If you do not have lung or airway problems, I would further recommend that you switch to atenolol 50 mg x 2 tb/d, or 25 mg x 2 tb/d, depending on the blood pressure figures, being a beta-blocker that has a better overall effect on heart rate and blood pressure, as well as decreasing the workload to the heart.I hope I was helpful with my answer. Take care. Good day. </s>