Heart Arrhythmias and Palpitations: When to Worry?
An irregularly beating heart is not always serious.
Dr. Marc Dufresne
Cardiologist
In simple terms
Extrasystoles are benign in most cases. But some arrhythmias require urgent management.
What you need to remember
- Benign Arrhythmias — Extrasystoles**: premature beats felt as "skipped beats".
- Arrhythmias to Watch For — Atrial fibrillation (AF)**: irregular and rapid atrial rhythm.
- When to Consult? — Palpitations accompanied by shortness of breath or chest pain
- Additional Examinations — ECG (electrocardiogram) is the first examination.
Palpitations—that uncomfortable sensation of feeling your heart beat—are one of the most frequent reasons for cardiology consultations. In the vast majority of cases, they are benign.
Benign Arrhythmias
- Extrasystoles: premature beats felt as "skipped beats". Very common, often exacerbated by coffee, stress, or lack of sleep.
- Sinus tachycardia: normal acceleration of heart rate (exertion, emotion, fever).
Arrhythmias to Watch For
- Atrial fibrillation (AF): irregular and rapid atrial rhythm. Stroke risk multiplied by 5 if untreated.
- Ventricular tachycardia: potential emergency requiring immediate assessment.
- Symptomatic bradycardia: excessively slow rhythm with malaise, fatigue, or fainting.
When to Consult?
- Palpitations accompanied by shortness of breath or chest pain
- Malaise or loss of consciousness
- Prolonged episodes (> 30 minutes) of rapid and irregular rhythm
- Family history of sudden death
Additional Examinations
ECG (electrocardiogram) is the first examination. Holter (24-48h recording) captures intermittent arrhythmias. Connected watches can now detect atrial fibrillation with reasonable sensitivity.
The words explained
Medical terms used above, in everyday language.
- Symptom
- A sign you can feel or see that something is wrong, like pain, tiredness or a rash.
When should you see a doctor?
- Your symptoms last more than a few weeks or keep coming back.
- They get worse quickly, or stop you doing everyday things.
- You notice sudden pain, breathing trouble, fainting or bleeding — seek urgent care.
- You already take medication and want to change anything about it.
This article explains general health information. It does not replace advice from your own doctor.
Frequently asked questions
- What is Heart Arrhythmias and Palpitations: When to Worry??
- Extrasystoles are benign in most cases. But some arrhythmias require urgent management.
- What are the main symptoms or signs of Heart Arrhythmias and Palpitations: When to Worry??
- Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.
- When should you see a doctor for Heart Arrhythmias and Palpitations: When to Worry??
- See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.
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