Arrhythmiawhen the heartbeat loses its rhythm.
An arrhythmia is a heartbeat that is too fast, too slow or irregular, caused by a problem in the heart's electrical system. Many are harmless; some need treatment. The key is recording the rhythm while it is happening.
At a glance
- Often noticed as
- Palpitations, dizziness or fainting
- Confirmed with
- An ECG and a Holter recording
- Aim of care
- Identify the rhythm and treat what matters
- Followed up in
- General cardiology
Symptoms
Symptoms vary from person to person, and some people have none. These are the most common.
- Palpitations: racing, fluttering, thumping or skipping
- Dizziness or light-headedness
- Fainting, or nearly fainting
- Breathlessness
- Tiredness, especially with a slow heart rate
Causes and risk factors
- Extra beats, often with caffeine, stress or poor sleep
- Atrial fibrillation and other fast rhythms
- Age-related wear of the heart's wiring, causing slow rhythms
- Coronary artery disease, cardiomyopathy or valve disease
- Thyroid problems and some medicines
- Rarely, an inherited rhythm condition
How it is diagnosed
The diagnosis starts with your history and an examination. These are the tests most often used to confirm it.
- ECGAvailable in clinic
- Holter monitoringAvailable in clinic
- EchocardiographyAvailable in clinic
- Stress testingAvailable in clinic
How it is managed
Record the rhythm
An ECG, a Holter monitor or a smartwatch recording during symptoms shows what the rhythm really is.
Reassurance, when it is harmless
Many palpitations are extra beats that need no treatment once the heart is shown to be healthy.
Medicines
Medicines can slow a fast heart or prevent episodes.
Procedures, when needed
Ablation for some fast rhythms, or a pacemaker for slow ones, is arranged by referral.
General information, not a treatment plan. Your treatment is decided with you after an assessment.
Get emergency help now if you have
Call emergency services or go to the nearest emergency department. Do not wait for a clinic appointment.
- Fainting, especially during exercise
- Palpitations with chest pain
- Severe breathlessness with a racing heart
- A very fast heartbeat that does not settle with rest
Common questions
What if my heart is normal when I am in clinic?
That is common. A Holter monitor records over one or more days, and a smartwatch or phone ECG taken during an episode is very useful, so bring it with you.
Are palpitations dangerous?
Most are harmless extra beats. They are worth checking if they are frequent, come with fainting or chest pain, or you already have a heart condition.
Can I drink coffee?
In moderation, usually yes. If caffeine clearly triggers your symptoms, cutting down is sensible.
Other conditions
All conditions- Heart failureThe heart muscle is not pumping or filling as well as it should, so the body receives less than it needs.
- Atrial fibrillationAn irregular, often fast heartbeat that starts in the upper chambers and raises the risk of stroke.
- High blood pressurePressure in the arteries stays too high. It rarely causes symptoms, but it strains the heart and blood vessels over time.
- High cholesterolToo much cholesterol in the blood, which can build up in artery walls over many years.
- Coronary artery diseaseThe arteries that supply the heart muscle become narrowed by fatty plaque.
- CardiomyopathyA disease of the heart muscle itself, which may become thickened, stretched or stiff.
- Heart valve diseaseOne of the heart's four valves does not open fully or does not close properly.
- AnginaChest discomfort, usually on exertion, when the heart muscle briefly gets too little blood.
- Diabetes and the heartDiabetes raises the risk of heart and blood vessel disease, so the two are best managed together.
Living with this, or worried you might be?
Book a consultation or send a question on WhatsApp. Your history, results and treatment are reviewed in person, and the plan is explained to you before you leave.
This page explains a condition in general terms. It cannot diagnose you or replace an examination, and it is not a treatment plan. Do not change or stop a medicine without talking to your doctor. If your symptoms are severe, sudden or happening now, seek emergency care immediately.