Cardiac Condition Information

    Palpitations

    Palpitations are an awareness of your own heartbeat — felt as racing, pounding, fluttering, skipping or stopping. They are one of the most common symptoms that prompt a cardiology referral.

    Dr Matthew Balerdi provides rapid assessment for palpitations in Hull, Grimsby and Scunthorpe, including same-week ECG, ambulatory rhythm monitoring with the Zio XT patch, and echocardiography.

    What Are Palpitations?

    Palpitations describe a heightened awareness of your own heartbeat. People experience them differently — as a racing sensation, a pounding in the chest, a fluttering feeling, a skipped beat, or even the heart seeming to stop momentarily.

    The key principle is that palpitations are a symptom, not a diagnosis. They can be caused by a wide range of underlying rhythms, from completely harmless extra beats to arrhythmias that require treatment. The purpose of assessment is to identify what is producing the sensation.

    Racing

    A fast, regular or irregular heartbeat

    Pounding

    A forceful beat felt in the chest, neck or throat

    Fluttering

    A rapid, light sensation in the chest

    Skipping or stopping

    A missed beat followed by a stronger thud

    How Palpitations Feel

    The way palpitations feel can provide important diagnostic clues:

    Isolated thud or missed beat

    Suggests ectopic beats — usually benign extra beats

    Rapid and regular, sudden onset and offset

    Suggests supraventricular tachycardia (SVT)

    Rapid and irregular

    Suggests atrial fibrillation (AF)

    Fast with chest pain or breathlessness

    Suggests ventricular tachycardia (VT) — seek urgent assessment

    Causes of Palpitations

    Common Benign Causes

    The majority of palpitations are caused by harmless mechanisms:

    • Ectopic beats (extra beats from the atria or ventricles)
    • Sinus tachycardia (a normal fast heart rate response)
    • Heightened awareness of a normal heartbeat
    • Caffeine and stimulants
    • Anxiety and stress

    Causes Requiring Assessment

    Some palpitations reflect arrhythmias or conditions that need evaluation:

    • Atrial fibrillation (AF)
    • Supraventricular tachycardia (SVT)
    • Atrial flutter
    • Ventricular tachycardia (VT)
    • Wolff-Parkinson-White syndrome (WPW)
    • Anaemia or hyperthyroidism

    How Palpitations Are Investigated

    The goal of investigation is to capture your heart rhythm during symptoms. Dr Balerdi will select the most appropriate tests based on how often your palpitations occur.

    History & ECG

    A detailed history of your symptoms is the most important first step. A 12-lead ECG checks for resting rhythm abnormalities, and blood tests screen for anaemia, thyroid dysfunction and electrolyte imbalance.

    Heart Rhythm Monitoring

    Options include a 24–48 hour Holter monitor for daily symptoms, the Zio XT patch worn for up to 14 days for less frequent episodes, a KardiaMobile device for on-demand recording, or an implantable loop recorder for very infrequent events.

    Cardiac Imaging

    An echocardiogram may be recommended when palpitations are accompanied by significant symptoms or when structural heart disease is suspected. It provides a detailed assessment of heart structure and function.

    When to Seek Help

    Most palpitations are not emergencies, but some warrant urgent attention. Use the guidance below to decide on the appropriate level of response.

    Call 999

    • Collapse or loss of consciousness
    • Severe breathlessness or chest pain
    • Sustained very rapid heart rate

    Urgent Same-Day Assessment

    • Pre-syncope (feeling like you might faint)
    • Known heart disease with new palpitations
    • Sustained palpitations lasting over 30 minutes

    Routine Referral

    • Recurrent or distressing palpitations
    • Irregular pulse detected on self-check or device
    • Abnormal ECG finding

    Reviewed by Dr Matthew Balerdi, Consultant Imaging Cardiologist (FRCP) — Last reviewed: April 2026

    Concerned About Palpitations?

    Don't wait — early assessment can provide reassurance or identify treatable arrhythmias. Schedule your consultation today.