Breast implants are highly common medical devices, used for both reconstructive and cosmetic purposes globally. While initially considered inert and safe, a growing number of individuals have reported systemic health issues they attribute to the presence of their implants. This collective patient experience has brought increased attention to the potential for generalized symptoms to arise long after the initial surgery. Investigating a connection between these devices and systemic health complaints, such as changes in heart rhythm, is a significant area of current medical investigation.
The Connection to Breast Implant Illness
The collection of systemic symptoms reported by some women with breast implants is broadly referred to as Breast Implant Illness (BII). BII is a clinical syndrome based on a cluster of patient-reported complaints, not a single, universally accepted medical diagnosis with a specific test. Symptoms are varied and can appear at any time following implantation, ranging from months to many years later.
Common complaints include profound fatigue, joint and muscle pain, cognitive difficulties often described as “brain fog,” and general weakness. Cardiac issues are frequently reported by patients identifying with BII. Specifically, these patients report heart palpitations, a sensation of a racing heart (tachycardia), or irregular heartbeats. The presence of these cardiac complaints alongside other systemic symptoms suggests a possible underlying mechanism affecting multiple body systems.
Proposed Biological Mechanisms for Cardiac Symptoms
Heart rhythm irregularities in the context of BII are thought to stem from a systemic reaction to the foreign material. One primary hypothesis centers on chronic, low-grade inflammation and immune system activation. The body forms a scar capsule around the implant, and this continuous foreign body response can trigger the release of inflammatory molecules. This persistent inflammatory state may lead to system-wide dysregulation, potentially affecting the heart’s electrical system.
Another specific theory suggests that the immune response may generate autoantibodies that interfere directly with the autonomic nervous system (ANS). The ANS regulates involuntary bodily functions, including heart rate and rhythm, through various receptors. Research has found an association between palpitations and reduced levels of autoantibodies directed against these ANS receptors in women with silicone implants, suggesting an immune-mediated disruption to the heart’s regulatory signals.
Other proposed mechanisms include chemical leaching or “gel bleed” from the implant material. Trace elements or breakdown products could potentially be cardiotoxic or stimulate the immune system. Also, the formation of bacterial biofilms on the implant surface is thought to contribute to chronic infection and inflammation, further stressing the immune system and contributing to systemic symptoms.
Clinical Evaluation and Differential Diagnosis
When a patient with breast implants reports heart palpitations, a thorough clinical evaluation is required. The focus is first on ruling out common and potentially serious cardiac conditions. A physician typically performs an electrocardiogram (ECG) and may utilize a Holter monitor to record the heart’s electrical activity over 24 to 48 hours to identify rhythm abnormalities. Structural heart disease must be excluded before attributing symptoms to the implants.
The presence of implants can complicate the diagnostic process for cardiac issues. The physical devices can interfere with non-invasive tests, such as echocardiography and nuclear stress tests, by creating “attenuation artifacts.” This interference can lead to false-positive results on cardiac functional studies, which can be misleading.
The differential diagnosis must also exclude other non-implant-related causes of palpitations. These include thyroid dysfunction, anxiety disorders, medication side effects, and anemia. Blood work often includes testing for inflammatory markers and autoantibodies, such as antinuclear antibodies (ANA). This testing can provide evidence of a generalized autoimmune or inflammatory process that may support a BII diagnosis.
Explantation and Symptom Resolution
If other medical causes have been ruled out and a strong clinical suspicion of BII remains, explantation—the surgical removal of the breast implants—is the recognized treatment strategy. The goal is to remove the foreign material and the surrounding scar tissue, known as the capsule. This is often performed through a total capsulectomy, though the necessity of an “en bloc” removal for symptom resolution is debated.
Following explantation, many patients report significant improvement in systemic symptoms, including the resolution of heart palpitations. Studies indicate that a high percentage of women, often over 80%, experience complete or partial improvement in their overall symptoms after removal. Symptom relief can be rapid for some, occurring within the first few weeks or months.
For other individuals, symptom resolution may be more gradual, potentially taking months or longer as the body recovers from chronic inflammation. While explantation is the most effective treatment for BII, outcomes are not guaranteed for every patient. Early removal, particularly within ten years of implantation, has been associated with better rates of symptom improvement.