What does it mean to have an irregular heartbeat?

What You Need to Know About Abnormal Heart Rhythms

The most common types of abnormal heart rhythms are:


Tachycardia means that your heart is beating too fast. For example, a normal heart beats 60 to 100 times per minute in adults. Tachycardia is any resting heart rate over 100 beats per minute (BPM).

There are three subtypes of tachycardia:

  • Supraventricular tachycardia occurs in the upper chambers of your heart known as the atria.
  • Ventricular tachycardia occurs in the lower chambers known as the ventricles.
  • Sinus tachycardia is a normal increase in the heart rate that may occur when you’re sick or excited. With sinus tachycardia, your heartbeat returns to normal once you get better or become calm.

Atrial fibrillation

This disorganized heart rhythm occurs in the upper chambers of the heart. It’s the most common arrhythmia.

Atrial fibrillation, or AFib, occurs when many unstable electrical impulses misfire and may result in the atria quivering out of control.

AFib causes the heart rate to increase and become erratic. It can elevate your heart rate to 100 to 200 BPM, which is a lot faster than the normal 60 to 100 BPM.

Atrial flutter

An atrial flutter (AFL) typically occurs in the right atrium, which is one of the two upper chambers of the heart. However, it may occur in the left atrium as well.

The condition is caused by a single electrical impulse that travels rapidly in the affected atrium. This often results in a fast heart rate, but it’s a more regular rhythm.


If you’re bradycardic, it means you have a slow heart rate (less than 60 BPM). Bradycardia generally occurs when the electrical signals traveling from the atria to the ventricles become disrupted.

Some athletes have slower heart rates because they are in excellent physical condition, and this isn’t usually the result of a heart problem.

Ventricular fibrillation

Ventricular fibrillation (VF) can stop the heart from beating and cause cardiac arrest. It occurs in the ventricles, which are unable to pump blood out of your heart to the body and brain due to the irregular heartbeat.

VF is a serious condition that may cause death if it’s not immediately treated.

Premature contractions

With most premature contractions, the heart appears to skip a beat when the pulse is taken in the wrist or chest. The skipped beat is so faint or weak that it’s not heard or felt.

Other types of premature contractions include extra beats and early beats. All three types may occur in the upper or lower heart chambers.

When should you get an irregular heartbeat checked?

“It can be tempting to jump to the worst-case scenario when it comes to your heart, and to think that an irregular heartbeat is a sign of a serious disease,” says Dr. Hummel. “But it doesn’t always require treatment.”
The possible causes of an irregular heartbeat can vary widely – from too much caffeine to a more potentially dangerous condition of having your blood pressure skyrocket or plummet.
There are several types of irregular heartbeats. Dr. Hummel explains some people experience an extra heartbeat, a skipped beat, too fast of a beat (called tachycardia) or too slow of a beat (called bradycardia).

When to see a doctor immediately?

Dr. Hummel says it can be difficult for most people to know if an irregular heartbeat is a sign of something more serious.
Go immediately if you have additional symptoms with your irregular heartbeat or you’ve had a heart attack or other heart stress. According to Dr. Hummel, those symptoms include fainting, dizziness, chest pain, swelling in your leg or shortness of breath.
“There’s a big difference between sitting in a chair and noticing your heart skipping and having fluttering that makes you feel like I’m going to pass out,” says Dr. Hummel.
“The other issue is whether your heart is structurally normal. If it’s not, abnormal heart rhythms more commonly will increase your risk of stroke or sudden death.”

Look at your actions and environment

Dr. Hummel says external factors could be causing disruptions in your heart rhythm:

  • Too much caffeine or alcohol
  • Dehydration
  • Drug abuse
  • Fever
  • Anemia
  • Emotional distress
  • Sleep apnea
  • Pregnancy
  • Eating or exercising

Dr. Hummel advises you make notes of when you experience irregular heartbeats and share this information with your doctor. Remember, not all unusual heart rhythms will require treatment.
“Abnormal heartbeats can come and go, especially in young people,” states Dr. Hummel.

What type of tests can help diagnose an irregular heartbeat?

The first test is usually an echocardiogram, which looks at the structure and function of your heart. You may have an exercise stress test on a treadmill or stationary bike to measure your heart’s response to exertion. Patients might also be asked to wear a portable monitoring device (called a Holter monitor) for 24 to 48 hours that records every heartbeat and monitors for irregular heart rhythm.
“We have a wide range of diagnostic tools and we work to figure out what the cause is by looking at your actions and your medical history,” explains Dr. Hummel.
He points out some people may have an inherited abnormal heart rhythm. Learn more about genetic heart testing.

The bottom line on your irregular heartbeat

• If you have skipped heartbeats, you need to pay attention to your body and then get an assessment.
• The urgency of that assessment is determined by whether you have additional symptoms or structural heart disease.

Treatments for heart and circulatory conditions

What is an arrhythmia?

Your heart is controlled by a conduction system which sends out electrical impulses. This causes a heartbeat.

If the impulses travel in a different direction to normal, you might experience an abnormal heart rhythm.

There are different types of arrhythmia. The type you have depends on where in your heart the electrical impulses start and how it affects the speed of your heart rate.

Common types of arrhythmia:

  • Atrial fibrillation is an irregular, often fast heart rhythm.
  • Tachycardias are rhythms where your heart beats faster than 90 beats per minute (bpm). Common types are supraventricular tachycardia (SVT) and sinus tachycardia (ST).
  • Bradycardias are slow, regular heart rhythms, where your heartbeat is 60 bpm or below.
  • Heart blocks are types of arrhythmia caused by a delay in the conduction system between the top and bottom chambers of the heart which can cause a slower than average heart rate.
  • Atrial flutter is usually a fast heart rhythm where the atria contract at a very fast rate compared to the ventricles. This can cause the atria to beat extremely fast, sometimes up to 300 bpm.
  • Tachybrady syndrome (sick sinus syndrome) causes periods of very fast or slow heart beats.

What are the symptoms of an arrhythmia?

The symptoms you have depend on what type of arrhythmia you have. The most common symptoms include:

  • palpitations (a thumping or fluttering sensation in your chest)
  • dizziness
  • feeling as if you may ‘black out’
  • breathlessness
  • chest discomfort
  • feeling tired.

When should I see my GP?

It’s normal for your heart to beat at different rates during the day. It’ll usually be slower when you’re resting but may be faster when you’re exercising, anxious or excited.

Some abnormal heart rhythms and palpitations are harmless and settle down on their own. You should speak to your GP about your symptoms if:

  • your palpitations last a long time, don’t improve or get worse
  • you have a history of heart problems
  • you’re concerned about the palpitations.

You should dial 999 for an ambulance if:

  • along with palpitations, you start to feel short of breath, have chest pain or feel faint or dizzy.

What causes an arrhythmia?

Some causes of arrhythmias are:

  • a heart attack
  • heart failure
  • cardiomyopathy
  • coronary heart disease.

Some abnormal heart rhythms can be caused by inherited conditions, such as Long QT syndrome, Brugada syndrome, CPVT and PCCD.

If this is the case for you, your doctor will talk to you about having family members tested. Although this can be scary, it can help them know if they need treatment now or in the future.

How is an arrhythmia diagnosed?

Your GP might refer you for tests including:

  • an ECG
  • an electrophysiological (EP) study.

How is an arrhythmia treated?

Your treatment will depend on your type of arrhythmia. Common treatments include:

  • medication
  • cardioversion
  • catheter ablation
  • inserting an implantable cardioverter defibrillator (ICD) or pacemaker.

Living with an arrhythmia

Most arrhythmias are manageable. This means that with the right treatment you can carry on living as you were before you were diagnosed.

Living with an abnormal heart rhythm can be emotionally challenging for you and your family. It’s important to manage anxiety and stress and get support from your GP or loved ones if needed.

You might have to think about practical matters like driving, going on holiday and returning to work after being diagnosed with an arrhythmia.
If your ability to drive will be affected, you must let your insurance company and the DVLA know. Your GP can advise on whether you need to do this.

If your job has an occupational health department, talk to them if you think your job role might have to be altered to better suit you.

  • Read about Jim, who has atrial fibrillation.

Symptoms & Diagnosis

Certain heart rhythms, especially those that last long enough to affect the heart’s function, can be serious or even deadly.

  • Palpitations or Skipped Beats
    Although it may seem as if the heart missed a beat, it has really had an early heartbeat — an extra beat that happens before the heart has a chance to fill with blood thereby resulting in a pause.
  • Fluttering
    A fluttering sensation (like butterflies in the chest) is usually due to extra or “skipped beats” that occur one right after the other, or may be caused by other kinds of abnormal heart rhythms.
  • Slow Heartbeat – Bradycardia
    If the heartbeat is too slow (usually below 60 beats per minute), not enough blood carrying oxygen flows through the body.
The symptoms of a slow heartbeat are:
  • Fatigue (feeling tired)
  • Dizziness (spinning sensation)
  • Lightheadedness
  • Fainting or near Fainting
  • Rapid Heartbeat – Tachycardia
    When the heart beats too quickly (usually above 100 beats per minute), the lower chambers, or ventricles, do not have enough time to fill with blood, so they cannot effectively pump blood to the rest of the body.
The symptoms of a rapid heartbeat are:
  • Skipping a beat
  • Beating out of rhythm
  • Palpitations
  • Fast heart beat or racing heartbeat
  • Shortness of breath
  • Chest pain
  • Dizziness
  • Lightheadedness
  • Fainting or near Fainting

Chaotic, quivering or irregular rhythm

Sudden rapid, irregular and chaotic heartbeats may be a sign of a common heart rhythm problem called atrial fibrillation (AFib). Rarely, passing out, or Fainting, may be caused by the most dangerous arrhythmia, ventricular fibrillation (VF). VF is the number one cause of sudden cardiac death. Within seconds, the person loses consciousness and, without immediate emergency treatment, will die within minutes.

  • Almost Fainting – Presyncope
    Sometimes people have symptoms before they faint. Presyncope can be a sign of a heart rhythm disorder and should be evaluated carefully.
Symptoms include:
  • Dizziness, lightheadedness, or vertigo (spinning)
  • Blurred or narrowed (tunnel) vision
  • Sweating
  • Nausea (feeling sick in the stomach) and/or vomiting
  • Stomachache/abdominal discomfort
  • Heart palpitations
  • Headache
  • Confusion and/or difficulty speaking clearly or coherently (not making any sense)
  • Fainting – Syncope
    Fainting from a heart rhythm disorder is more likely to happen suddenly and without warning than Fainting from other causes, such as dehydration or low blood sugar. Any sudden loss of consciousness should be evaluated by a doctor. In some cases, Fainting is the only warning sign of a dangerous heart rhythm that could cause sudden cardiac death.

What is Electrophysiology?

Electrophysiology is a subspecialty branch of cardiology. An electrophysiologist (EP) is highly trained in the management of electrical properties of the heart, and is the most knowledgeable doctor to deal with the many often complex options for treating heart beat, or heart rhythm, disorders. If you or your doctor feels that you are experiencing a problem related to an abnormal heart beat, seeing an EP may provide you with the best chance of having this problem properly diagnosed and may offer the best options for treatment.

Normal hearts beat 60—100 times every minute. When your heart beats more than 100 times each minute, that’s considered high (called tachycardia in the medical world). Fast heartbeats can last for seconds to hours.

Not all cases of a racing heartbeat are dangerous. Many everyday situations that aren’t related to heart problems can cause your heart to race. These can include the following:

  • heavy exercise
  • stress, fear, anxiety, or panic attacks
  • low blood sugar or low blood pressure
  • fevers, anemia, and dehydration
  • pregnancy or menstruation
  • too much alcohol, caffeine, or nicotine
  • illegal drugs like ecstasy, methamphetamines, or cocaine

If you notice that your heart is beating faster than normal, look for obvious explanations first:

  • Are you stressed out?
  • Have you had more caffeine than usual?
  • Is your blood sugar low?

You can also try keeping a diary of your symptoms and write down what you were doing before you started to notice your heart was beating fast. Recording when your heart rate goes up can help your doctor better pinpoint what’s causing it.

If you notice that your heart is racing a lot and you’re not exercising or stressed (for example), then you should think strongly about seeing a doctor.

Heart Diseases That Can Cause a Racing Heart

Sometimes a fast or irregular heartbeat can be a sign of a serious heart condition. These conditions include the following:

  • heart failure
  • a past heart attack
  • coronary artery disease (CAD)
  • problems with your heart’s valves or muscles
  • atrial fibrillation

If your doctor thinks you may have one of these conditions, your doctor may give you an EKG, a chest X-ray, or an echocardiogram (echo test) to diagnose what’s wrong.

Unless your heart is racing or otherwise acting up, you probably don’t often think about how this all-important organ functions. As you read this, your heart is performing an incredible balancing act that’s crucial to keeping you alive and healthy.

“The heart beats because of electricity,” Shephal Doshi, M.D., director of cardiac electrophysiology at Providence Saint John’s Health Center in Santa Monica, California, tells SELF. No, not the type that keeps your lights on, although that would be interesting. These are electrical impulses from a group of cells in your heart’s right atrium (chamber) that act like your own internal pacemaker. These cells, known as your sinoatrial (SA) node, tell your heart when and how to beat in order to send oxygen-rich blood throughout your body.

At rest, it’s normal for your heart to respond to these signals by beating anywhere from 60 to 100 times per minute. Anything higher than that is known as tachycardia, the fancy way of describing the sensation that your heart is galloping a mile a minute. When your heart starts pounding, your first thought might be, OMG, this is it, I’m having a heart attack. But a heart attack is most likely to cause symptoms like pain in your jaw, neck, back, arms, or shoulders, discomfort or pain in your chest, shortness of breath, fatigue, nausea, and vomiting. If your heartbeat feels out of control, a heart attack probably isn’t to blame. Instead, here are 10 possible reasons why your heart is racing.

1. You’re stressed.

When you encounter something stressful, your sympathetic nervous system and adrenal glands release a surge of norepinephrine, also known as adrenaline, Camille Frazier-Mills, M.D., a cardiologist at Duke Electrophysiology Clinic, tells SELF. Receptors in your heart respond to these triggers and can make your heart rate pick up. If you can’t immediately solve whatever’s making you stressed, try deep breathing to at least help you feel better in the moment. The Mayo Clinic suggests taking deep breaths in through your nose so that you feel your stomach rise, not your chest, and exhaling through your nose as well. Focus on your breath and the rise and fall of your abdomen throughout.

2. You’re beyond wired on caffeine.

While most people can handle a certain level of caffeine just fine, overdoing it can make your heart speed up. “Caffeine is a stimulant that can cause the release of adrenaline and make your heart beat faster,” Dr. Doshi says.

According to the Mayo Clinic, it’s safe for adults to have up to 400 milligrams of caffeine a day, or around the amount in four cups of coffee, 10 cans of soda, or two energy drinks (caffeine content varies based on the specific beverage).

“A bunch of patients come to see me with an elevated heart rate, then they tell me they drink multiple highly caffeinated beverages daily,” Dr. Mills-Frazier says. “They’re revving themselves up.” This is most likely to happen if you’ve had too much caffeine, but it could also happen in response to small amounts if you’re just sensitive to this stimulant. Try cutting back on caffeine gradually to see if it reduces your racing heart. If not, get in touch with your doctor.

3. You have a cold or fever.

If your pounding heart is accompanied by typical signs of a cold or fever, like an elevated temperature, coughing, and sneezing, this is likely the culprit. Battling an infection requires your body to work harder than usual, and that includes making your heart beat faster in order to fight for homeostasis (its usual stable condition) and kick the infection to the curb, Dr. Mills-Frazier says.

4. You’re not getting enough sleep.

When you sleep, your body isn’t doing as much, so your heart can slow down. “Sleep is your time to reset. If you’re not getting that recovery phase, your adrenaline levels during the day can be higher,” Dr. Mills-Frazier says. Excess adrenaline charging through your system during the day can lead to a faster heartbeat. The National Sleep Foundation recommends adults get seven to nine hours of sleep per night. If you have trouble clocking those restful minutes, check out some tips for beating insomnia.

5. You’re on some kind of medication that affects your heart.

There are tons of them out there. “Whether it’s related to osteoporosis, allergies, ADHD, or another condition, a lot of medications will increase circulating adrenaline and cause someone to feel like their heart is racing,” Dr. Doshi says. This happens so often that doctors will often first ask which medications you’re taking when you tell them your heart is beating too quickly. Depending on your medication and medical history, a racing heart can be expected or a sign that you might need to try a different option. Only a doctor can tell you for sure.

6. You’re pregnant.

Pregnancy is one heck of a roller coaster for your body, including your heart. In order to support the growing pregnancy, your blood volume goes up, and your heart has to work harder to pump out that extra blood, leading to a higher heart rate, Dr. Doshi says. This is completely normal, but if you’re concerned, check in with your ob/gyn just to make sure.

7. You’re having a panic attack.

Around 2 to 3 percent of Americans experience an episode of panic disorder in any given year (otherwise known as a panic attack), according to the American Academy of Anxiety and Depression. Panic attacks are characterized by sudden, unexpected, often paralyzing bouts of fear. A rapid heartbeat is a common symptom, and it can terrify people even more. “You start releasing more adrenaline, and it becomes this vicious cycle,” Dr. Mills-Frazier says, adding that sometimes it’s difficult to tease out whether a rapid heartbeat contributes to someone having a panic attack or vice versa. If you think you’re having panic attacks, don’t suffer in silence. Talk to your doctor or therapist to figure out which treatment option can best help you avoid these awful episodes.

8. Your thyroid is in overdrive.

Your thyroid gland produces various hormones, like thyroxine and triiodothyronine, which affect a ton of your body’s systems, according to the Mayo Clinic. If you have hyperthyroidism, your thyroid is overactive and produces too much thyroxine, which in turn speeds up your body’s metabolism too much. This can result in a rapid or irregular heartbeat, along with symptoms like an increased appetite and sudden weight loss. There are plenty of medications out there to treat hyperthyroidism, including beta blockers to specifically address your quick heart rate.

9. You have anemia.

Anemia happens when your blood doesn’t provide enough oxygen throughout your body, according to the National Heart, Lung, and Blood Institute. This can occur if you don’t have enough red blood cells, or if you don’t have enough hemoglobin, the iron-rich protein that carries oxygen from your lungs to other parts of your body. In either instance, your heart has to work harder to get blood to every part of you, so you can experience a faster heart rate, Dr. Doshi says. This won’t be your only sign of anemia, though. If you have this blood disorder, you can also expect to feel things like fatigue, dizziness, headache, and pale skin.

10. You have a heart arrhythmia.

A heart arrhythmia happens when there’s some sort of electrical malfunction in your heart, which can cause it to beat irregularly. There are many forms, and they have different causes, but they can often make it feel like your heart is beating quickly or strangely out of nowhere. Although an arrhythmia sounds like a dire diagnosis from Grey’s Anatomy, they actually aren’t always serious. “Many arrhythmias are not life-threatening,” Dr. Mills-Frazier says. “Obviously with higher-risk patients, they can be, but they’re often treatable.” Arrhythmias often present with side effects like dizziness, nausea, fainting, chest pain, and shortness of breath, according to the American Heart Association.

Ultimately, there are lots of reasons your heart may be racing.

Sometimes it’s nothing major. Other times, especially when accompanied by symptoms like feeling lightheaded or dizzy, having chest pain, or feeling fatigue, it can be a sign that you should see a doctor. “It doesn’t matter how healthy you are or how healthy you think you are,” Dr. Doshi says. “If your heart doesn’t feel right for you, it’s worth getting a checkup.”


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Heart Palpitations

You may feel palpitations in your chest, throat, or neck during activity or when you are sitting still or lying down. Strong emotions, physical activity, some medicines, caffeine, alcohol, nicotine, or illegal drugs may cause palpitations. Medical conditions such as thyroid disease, low blood sugar, anemia, and low blood pressure also may cause palpitations. Heart palpitations may be a sign or symptom of arrhythmia, an irregular heartbeat, or other heart conditions such as heart attack, heart failure, heart valve disease, or cardiomyopathy.

Although palpitations are very common and usually harmless, they can be frightening when they happen and may cause anxiety. Most go away on their own. To prevent palpitations, you can try to avoid things that trigger them, such as stress, alcohol, or caffeine. You also may prevent palpitations by treating any other medical condition that may be causing them.

Palpitations may be a sign of more serious heart problems. You should seek medical attention immediately if you have palpitations and feel dizzy or confused, have trouble breathing, think you may faint, or have pain or tightness in your chest. Your doctor will perform a physical exam and possibly other tests. These tests may include an electrocardiogram (EKG), a stress test, or the use of a Holter or event monitor to study your heart’s activity. Treatment for palpitations will depend on the cause.

Visit Heart palpitations for more information about this topic.

What Is Arrhythmia?

Arrhythmias are named and categorized based on three points:

  • rate (whether it’s too slow or too fast)
  • origin (whether it’s in the ventricles or the atria)
  • regularity

Bradycardia is a slow heartbeat. It’s defined as a resting heart rate of fewer than 60 beats per minute. Not all bradycardias are a problem. Athletes and people who are physically fit often have bradycardias. Their resting heart rates may be fewer than 60 beats per minute because their hearts are more efficient and can pump adequate blood with fewer beats. However, a slow heart rate might mean your heart doesn’t beat frequently enough to ensure adequate blood flow throughout your body.

Types of bradycardia include:

Sick sinus: The sinus node is responsible for setting the pace of your heart. If it isn’t sending electrical impulses properly, your heart may pump too slowly or irregularly. Scarring near the sinus node from heart disease or a heart attack may also slow down or block the electrical impulses as they try to travel through the heart.

Conduction block: If your heart’s electrical pathways are blocked, the chambers of the heart may contract slowly or not at all. A block can happen anywhere along the heart’s electrical pathways—between the sinus node and atrioventricular (AV) node, or between the AV node and the ventricles. There may be no signs of these blocks other than skipped or slowed heartbeats.

Tachycardia is a fast heartbeat. It’s defined as a resting heart rate of more than 100 beats per minute. The two most common types of tachycardia are supraventricular tachycardia and ventricular tachycardia.

Supraventricular tachycardia: Supraventricular tachycardia (SVT) is any arrhythmia that begins above the ventricle. SVTs are usually identified by a burst of rapid heartbeats that can be chronic or begin and end suddenly. These bursts can last a few seconds or several hours and may cause your heart to beat more than 160 times per minute. The most common SVTs include atrial fibrillation and atrial flutter.

Atrial fibrillation: If you have atrial fibrillation (AF), your atrium beats very rapidly (as fast as 240 to 350 beats per minute). The atria move so rapidly that they aren’t able to contract completely. Instead, they quiver, or fibrillate. This can cause discomfort, but not a rapid pulse. However, some of these atrial beats can transfer to the ventricles and may cause a high pulse rate.

AF primarily affects older people. Your risk of developing this arrhythmia increases past age 60, mostly due to the wear an older heart experiences. The chances of developing AF are also high if you have or have had high blood pressure or other heart problems. AF can be dangerous. If left untreated, it can lead to more serious conditions, such as stroke.

Atrial flutter: The heartbeats in atrial flutter are more rhythmic and constant than the heartbeats in atrial fibrillation. Still, atrial flutter can come and go in sudden bursts. It can be life-threatening. This type of arrhythmia occurs most often in people with heart disease. It also often shows up in the first weeks after heart surgery.

Ventricular tachycardia: Ventricular tachycardia (VT) is an arrhythmia that begins in the ventricles of the heart. Most VT occurs in people who have had heart disease or heart-related problems, such as coronary artery disease or heart attack. VT is often caused by an electrical impulse traveling around a scarred part of the heart’s muscle. It can cause the ventricles to contract more than 200 times per minute. If left untreated, VT may increase your risk of developing more serious ventricular arrhythmias, such as ventricular fibrillation (VF).

Ventricular fibrillation: VF may have signs such as sudden, rapid, irregular, and chaotic heartbeats in the ventricle. These erratic electrical impulses, sometimes triggered by a heart attack, cause your heart’s ventricles to quiver (fibrillate). When you have this kind of arrhythmia, your ventricles can’t pump blood into your body, and your heart rate drops quickly. This makes your blood pressure fall and diminishes the blood supply to your body and organs. VF is the number one cause of sudden cardiac arrest.

Premature heartbeats

Premature heartbeats may result in the feeling that your heart has skipped a beat. In reality, your normal heart rhythm has been interrupted by a too-soon beat, and you’re experiencing an extra beat between two normal heartbeats.

Well Ahead Blog

It seems as though almost everyone has heard a cautionary tale about heart health. An unrecognized symptom, an undetected heart condition, or pushing your heart to its maximum capacity during practice or time outdoors can all produce a dangerous, and sometimes fatal, result. Stories like these have prompted awareness about heart conditions and heart health, and have also helped to increase knowledge of which symptoms to keep an eye out for.

Heart palpitations, the feeling of a rapid, fluttering, pounding, or otherwise irregular heartbeat, is one of those symptoms. When these occur during physical activity or on particularly warm days, it’s a cue to slow or stop what you’re doing. However, heart palpitations aren’t exclusive to situations like these. Anyone can be affected by that feeling of a fluttering heart, which is why understanding the causes and concerns associated with it can help you determine whether or not to worry.

“Heart palpitations can be alarming, because your heartbeat feels abnormal,” explains Richard R. McCurdy Jr., MD, Lankenau Heart Institute cardiologist at Riddle Hospital, part of Main Line Health. “Fortunately, most palpitations are not dangerous and often can be explained by external factors.”

These external factors can include exercise, emotions like stress or anxiety, or increased amounts of nicotine or caffeine. Certain medications can also trigger heart palpitations, including inhalers for asthma and over the counter cold treatments, so talk to your doctor about the potential side effects of your medications if you’re concerned.

Typically, when heart palpitations are caused by factors like these, it will feel as though your heart is pumping faster or harder than usual or you will notice skipped or fluttering heartbeats. These symptoms are usually felt in your chest, but can also be felt in the throat or neck, so don’t be alarmed if you notice symptoms in these places, as well.

However, if these palpitations last longer than a few seconds, or are associated with other symptoms, there may be some underlying medical concerns. If your palpitations are accompanied by dizziness, fainting, shortness of breath, or chest pain, you should seek medical attention.

“Palpitations can be caused by a wide range of abnormal heart rhythms. Some of these are actually relatively common and not dangerous at all. These palpitations will be very short, no more than a couple seconds, and not accompanied by any other symptoms. However, when palpitations last a few minutes or more, or are combined with other symptoms, that’s when it has the potential to be a bigger issue. It could mean that you are at risk for complications like heart failure or cardiac arrest,” says Dr. McCurdy.

Although results like these are rare, it’s important to understand the warning signs for serious cardiac issues like these. Reduce your risk for any heart problems by leading a healthy lifestyle. Quit smoking, eat a balanced diet and aim to exercise for 30 to 60 minutes five days per week.

This article is not a substitute for medical advice offered by your physician. If you notice repeated episodes of heart palpitations or have questions, make an appointment with your doctor, who can help you know for sure whether or not you should be concerned. Visit our website for a full list of Lankenau Heart Institute cardiologists in your area.

Patients who have had an irregular heart beat can’t ever be considered ‘cured’

Atrial fibrillation is the most common heart rhythm disturbance, affecting around 1.6 million people in the UK. Those with atrial fibrillation may be aware of noticeable heart palpitations, where their heart feels like it’s pounding, fluttering or beating irregularly. Sometimes atrial fibrillation does not cause any symptoms and a person who has it is completely unaware that their heart rate is irregular.

People with atrial fibrillation are much more likely to develop blood clots and suffer from strokes. To avoid strokes it is important for them to take drugs to prevent blood clotting. Sometimes atrial fibrillation seems to go away and the heart goes back to its normal rhythm -the condition may then be deemed to have ‘resolved’. Up until now it has been unclear as to whether the clot-prevention drugs can be safely stopped when the condition is ‘resolved’.

Now a study by researchers at the University of Birmingham, published today in The BMJ, has found that people whose heart rhythm returns to normal continue to be at high risk of stroke and should continue to be treated.

Researchers looked at patient records from 640 general practices throughout the UK and compared the frequency of strokes in three groups of people: those with ongoing atrial fibrillation; those whose records said that atrial fibrillation had resolved; and those who never had atrial fibrillation.

Dr Nicola Adderley, of the University of Birmingham’s Institute of Applied Health Research, said: “What we found was that strokes were least common in people who never had atrial fibrillation, and much more common in people whose records said their atrial fibrillation had been resolved.


“Significantly, in recent years we found that strokes were nearly as common in people whose atrial fibrillation had resolved as in those with ongoing atrial fibrillation.

“Therefore, we can conclude that people with resolved atrial fibrillation continue to be at high risk of stroke.”

The researchers also looked at patient treatment. What they found was that, while most people deemed to have atrial fibrillation as an ongoing condition continue to get the clot-prevention drugs they need, the vast majority of those whose atrial fibrillation had ‘resolved’ do not.

Dr Krish Nirantharakumar, of the University of Birmingham’s Institute of Applied Health Research, added: “Our research demonstrates that although people with resolved atrial fibrillation continue to be at high risk of stroke, they are not getting their prevention drugs.

“Worryingly, we found that the problem seems to be becoming more common, with our research showing an increasing number of people are recorded as having atrial fibrillation as resolved and are highly unlikely to be given medication to prevent stroke.”

The researchers said that in 2016 one in 10 people with atrial fibrillation — around 160,000 people in the UK — were classed to have had their condition resolved.


Professor Tom Marshall, of the University of Birmingham’s Institute of Applied Health Research, added: “One possibility as to why people whose atrial fibrillation has resolved continue to be at high risk of stroke is that it had not really resolved in the first instance.

“Atrial fibrillation can be present one day and absent the next, so giving someone the all-clear may be a mistake. Another possibility is that it can come back. Many people don’t know when they have this condition and it can come back without them or their doctor realising.

“GPs keep a register of people with atrial fibrillation, this means they are reviewed regularly and are prescribed clot-preventing drugs.

“But if the atrial fibrillation seems to have resolved they are taken off the register and rarely continue their treatment. It is as if they fall off the radar.

“We have shown they are still at high risk of stroke and should still be treated. We cannot ever safely consider atrial fibrillation to have resolved.”

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