Palpitations are sensations of racing heartbeats or the sensations of fluttering or pounding of the heart. Some people feel these sensations in the chest, some in the throat or neck. These might occur when the patient is active or at rest. Some people report waking up with this sensation.
Patients who also experience chest discomfort (heaviness, stuffiness, etc.), pain, fainting, severe shortness of breath or severe dizziness should be referred to an MD or to an ER.
Palpitations are often linked to stress and anxiety. Look for other signs of heart fire, heart yin deficiency, heart blood deficiency, heart qi deficiency, etc. Explore this in your intake, interview, pulse, tongue, etc. Also look at lifestyle. Caffeine and stimulant intake (coffee, energy drinks, lots of chocolate, street drugs, asthma medications, etc.), dehydration, and sleep apnea can all contribute to palpitations. Hyperthyroidism will drive this symptom as well.
This protocol should be done daily whenever possible. Two-three times a week is also acceptable. You can also teach this protocol to your patients and have them do acupressure on themselves once a day.
The element and channel interaction here is one of fire and wood. Wood is the mother of fire and can be used to treat palpitations and heart dysfunction. The points I suggest below addresses the wood (Liver) and fire (Heart) relationship as well as the relationship of water (Kidney) and fire (Heart). Earth points on the Spleen channel are also included as it is the Spleen that supplies the Qi and building blocks to make healthy blood.
Xin Ling 33.17 This is the guide point for the whole protocol. This is like a jet-fueled version of PC 6
St 37, 37
Option 2 - Three needle protocol
While not as thorough as the previous protocol, this still works to address the problem. This is definitely something you could teach your patients to do with acupressure every day. (The sides are somewhat arbitrary - the heart is predominantly to the left, so PC 6 is placed on the left. No problem if you need to switch sides. You could even needle PC 6 bilaterally if you keep the hand with Ling Gu and Da Bai resting on the lateral aspect like you do when you needle these points.)
Some patients who have palpitations will have a literal heart problem. Some will be stress and anxiety patients, menopausal patients, etc. Look for the underlying condition causing the palpitations. If you find stress and anxiousness, consider adding the following.
Autonomic + Shenmen
Ren 17 This is the front-mu of the pericardium, an influential point of Qi, and is indicated for asthma, chest pain, chest fullness/stuffiness, and palpitations.