How to treat or cure palpitations

Most palpitations are harmless and need only reassurance and trigger control. Treatment depends on the cause.

Step 1: find out why

• Examination and ECG: a heart tracing during symptoms is the best clue
• Blood tests: blood count, thyroid, electrolytes and sugar
• Heart monitoring: Holter, event recorder or smartwatch ECG for occasional episodes
• Echocardiogram or stress test if heart disease is suspected

Step 2: treat the cause

• Treat anaemia, thyroid disease, infection and electrolyte problems
• Reduce caffeine, alcohol and nicotine
• Help anxiety with counselling, relaxation and sleep
• Review medicines that raise heart rate

Step 3: treat the rhythm if needed

• Beta-blockers or other heart rhythm medicines
• Blood thinners if atrial fibrillation puts you at risk of stroke
• Catheter ablation for SVT and some other rhythms, which can often cure the problem
• Pacemaker or defibrillator for selected people

Emergency treatment

Chest pain, fainting or severe breathlessness with palpitations needs emergency care, with ECG, monitoring and sometimes cardioversion.

Complementary approaches

Yoga, breathing and Ayurvedic stress care may help well-being. They are not a replacement for finding the cause. Tell your doctor about any herbs you take.

What to avoid

Self-treating with energy tonics, stimulants or unregulated heart tablets.

See a doctor if palpitations are frequent, long, or accompanied by other symptoms. Call 112 for emergencies.

When to get help

See a doctor if palpitations are new, frequent, last more than a few minutes, or come with dizziness, chest discomfort or breathlessness. An ECG, simple blood tests and a heart rhythm monitor can usually find the cause. Call 112 for chest pain, fainting or severe breathlessness.

Remember

Diagnosis first, then treatment. Many causes can be treated well.