Understanding Palpitations
Palpitations are the awareness of one’s own heartbeat and are a frequent presenting symptom in Cardiology. Patients describe them in various ways: a racing heart, fluttering, thumping, or a sense that the heart is “skipping a beat.” Whilst palpitations are often benign, they can in certain cases represent an underlying heart rhythm disorder (arrhythmia) that requires treatment.
Dr Navin Chandra has extensive expertise in the investigation and management of arrhythmias. A precise diagnosis is essential, as the optimal treatment differs significantly between conditions such as atrial fibrillation, supraventricular tachycardia (SVT), ventricular ectopics, or Wolff-Parkinson-White syndrome. Early and accurate diagnosis avoids unnecessary anxiety and ensures patients receive appropriately targeted therapy.
Symptoms
- Rapid or racing heartbeat (tachycardia)
- Irregular or "skipped" heartbeat
- Pounding sensation in the chest or neck
- Palpitations triggered by caffeine, alcohol or stress
- Palpitations with associated light-headedness
- Sudden-onset and sudden-offset episodes
Common Causes
- Atrial fibrillation (AF) or Atrial flutter
- Supraventricular tachycardia (SVT)
- Ventricular ectopic beats
- Ventricular tachycardia
- Wolff-Parkinson-White syndrome
- Thyroid dysfunction or anaemia
Diagnostic & Treatment Options
The investigation of palpitations is guided by the frequency and duration of symptoms, associated features, and individual patient risk factors. Dr Chandra selects the most appropriate monitoring technology to capture the rhythm disturbance and guide definitive treatment.
- Resting 12-lead ECG
- Ambulatory Holter monitoring (24–48 hour)
- 7-day or 14-day event recording
- Implantable loop recorder (ILR) insertion
- Echocardiogram to assess cardiac structure
- Antiarrhythmic medication and rate control therapy
- Cardiac electrophysiology study & catheter ablation referral for suitable patients
- Anticoagulation for AF stroke risk reduction
Frequently Asked Questions
Are palpitations always a sign of a heart problem?
Not always. Many palpitations arise from benign ectopic beats, which are early heartbeats that nearly everyone experiences at some point. However, palpitations associated with fainting, chest pain, breathlessness, or a strong family history of sudden cardiac death warrant specialist evaluation. Dr Chandra’s comprehensive assessment distinguishes benign from clinically significant arrhythmias, giving patients the reassurance they need.
What is atrial fibrillation (AF) and how is it treated?
Atrial fibrillation is the most common sustained heart rhythm disorder, characterised by chaotic electrical activity in the heart’s upper chambers. It can cause palpitations, breathlessness, and fatigue, and carries an increased risk of stroke if left untreated. Treatment options include rate control with medication, normal rhythm restoration (cardioversion or ablation), and anticoagulation to reduce stroke risk. Dr Chandra tailors the treatment approach to each individual patient’s circumstances.
My palpitations are infrequent will you still be able to diagnose them?
This is a common challenge in arrhythmia management. For infrequent symptoms, a standard 24-hour monitor may be insufficient to capture the episode. Dr Chandra has access to extended event recorders and, where symptoms are very intermittent, implantable loop recorders — small devices inserted just beneath the skin that continuously monitor heart rhythm for up to three years.
Can catheter ablation cure my palpitations?
Catheter ablation is a minimally invasive procedure that targets the electrical pathways responsible for certain arrhythmias. It is highly effective for conditions such as SVT, AF, and atrial flutter. Success rates vary by arrhythmia type and patient characteristics. Dr Chandra will discuss whether ablation is appropriate for you and, if so, arrange a referral to a specialist Cardiac Electrophysiology centre.