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What is an arrhythmia?

Arrhythmias are abnormalities of the heart rhythm.  These may cause symptoms such as palpitations, chest pain, blackouts (syncope), shortness of breath and dizzy spells.

What is a palpitation?

A palpitation is an unpleasant awareness of your heart rhythm.  The causes of these symptoms vary from very benign conditions, right through to more serious heart conditions.

How do I know if a heart palpitation is serious?

It can be difficult to assess whether a palpitation is due to a serious underlying condition or not. However if you experience blackouts, shortness of breath or chest pain associated with your palpitation then you should seek urgent medical advice. Other palpitations may also need further investigation and you should start by seeking advice from your family doctor.

What tests are done to investigate palpitations?

Patients with palpitations often need a number of different test, these include ECGs, ECHO scans and holter monitors.  Further tests may be needed, depending on the results of the basic tests.

What is an ECG?

ECG | Dr. Raj Khiani | Arrhythmia

A 12-lead ECG involves electrodes attached to the chest and limbs and records the electrical activity of the heart.

What is a holter?

Woman wearing holter monitor | Dr. Raj Khiani | Arrhythmia

A holter monitor is attached to the patient and they can then continue with their normal activities, a 3 lead ECG is recorded and can help diagnose abnormal heart rhythms.

What is an echo?

Doctor performing an echo | Dr. Raj Khiani | Arrhythmia

An echo scan is an ultrasound scan of the heart, it involves a technician who places a probe on the chest and records images of the heart structure and flow across the heart valves. It is a very useful first line test to assess the structure and function of the heart, including the pumping chambers and valves.


Ectopic beats are a common cause of palpitations. They often cause a sensation of a skipped beat or an extra beat. If they originate from the top chambers of the heart they are called atrial ectopics, or if they arise from the lower chambers of the heart they are called “ventricular ectopics.”

Atrial Fibrillation (AF)

AF is a common heart arrhythmia. It results in an irregular heart rhythm, which is often felt as a heart palpitation. It is associated with rapid heart rates, which need controlling with medication.  It is also associated with clots forming in the heart which can be thrown off to the brain.  If this happens then the patient can suffer a disabling stroke.  To try and prevent this, patients with AF are commonly treated with blood thinners, called anticoagulants.

How is AF diagnosed?

AF can be diagnosed with a 12-lead ECG, especially if it is persistent. In some cases AF comes and goes and can only be diagnosed with other tests, such as holter monitors. There are a number of other treatments available for patients with AF and these include: pacemaker implant, ablation, cardioversion and LAAO devices.These are highly specialised treatments and for further information about these treatments, please discuss these with your cardiologist.

Useful websites

The following websites can provide useful further information about palpitations and their causes and treatments:

British Heart Foundation

Arrhythmia Alliance

AFIB Matters

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