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Difference Between Palpitations and Arrhythmia

Palpitations are a fluttering feeling in the chest. An arrhythmia is an abnormal contraction of the heart muscles.

What are Palpitations?


Palpitations are when a person feels like their heart is skipping or fluttering.


The sensation of a heart palpitation is due to some change in how the heart is functioning. It can be due to heart disease but this is not always the case.  The palpitations sometimes happen if the heart is contracting too fast or a beat is skipped. It can even happen during exercise or when a person is tired. Palpitations are common and may signal heart disease especially if other symptoms like chest pain, occur.

Symptoms and complications:

The symptoms of palpitations include a feeling of the heart skipping a beat, beating abnormally, or too fast. Not all palpitations mean heart disease because even stress can cause the sensation. Further evaluation is needed to rule out any underlying cardiac issues. Palpitations due to a cardiac condition can have complications that are life-threatening and may have additional signs like chest pain and fainting.


The diagnosis of palpitations is based on the patient’s description of symptoms. A medical history, intake of any drugs or caffeine is noted. Doctors listen to the heart and take the pulse rate. The patient may also undergo ECG testing and cardiac ultrasound to rule out cardiac illness. 


Treatment depends on if the palpitations are caused by an underlying condition. Lifestyle changes may be suggested if the palpitations are due to stress or excess intake of caffeine.

What is Arrhythmia?


An arrhythmia is when the heartbeat is abnormal due to something wrong with how the chambers of the heart are contracting.


Arrythmias happen because something goes wrong with the nerve impulses that stimulate the heart muscle to contract. Abnormal electrical conduction can be a congenital problem or due to factors such as abnormal electrolytes like low potassium levels, or problems with the thyroid gland hormone levels.

Symptoms and complications:

There may be no obvious signs of arrhythmia or there can be palpitations and other signs. Other symptoms include dizziness, fainting, difficulty breathing, and pain in the chest. Arrhythmias can be dangerous and can result in sudden cardiac death.


The diagnosis of an arrhythmia is done by doing an ECG, which will show abnormalities in how the heart is contracting. 


Treatment includes a variety of methods including cardiac ablation, pacemaker implantation, cardioversion, medication, or surgery. Surgery is less commonly done but is needed sometimes when a valve repair is needed. Cardioversion may require defibrillation of the heart to return it to a normal rhythm.

Difference between Palpitations and Arrhythmia


Palpitations are sensations of the heart fluttering. An arrhythmia is when there is an abnormal heartbeat.


The causes of palpitations include anxiety, underlying heart condition, or caffeine. The reasons for having arrythmia include low electrolyte levels, illness, congenital heart disease, and thyroid problems.


In the case of palpitations, the heart feels like it is fluttering or missing beats. In the case of an arrhythmia, there may be palpitations, chest pain, dizziness, and fainting.


The complications of palpitations depend on the cause and sometimes it can mean an actual arrhythmia. The most dangerous risk of arrhythmia is sudden cardiac death.


Palpitations often require no treatment but it depends on the reason for the condition. Arrhythmias may be treated in various ways including cardiac ablation, surgery, cardioversion, and medication.

Table comparing Palpitations and Arrhythmia

Summary of Palpitations Vs. Arrhythmia

  • Palpitations and arrhythmias can both make a person feel like the heart is not beating normally.
  • While palpitations are not necessarily a sign of a problem, an arrhythmia usually is a sign that something is wrong.
  • Medication and more invasive methods including cardioversion or pacemaker implantation may be needed if you have an arrhythmia.
  • Arrythmias can be dangerous and need to be treated.


Do palpitations always mean arrhythmia?

No, palpitations may mean you have an arrhythmia but this is not always the case since anxiety or even drinking too much coffee (which is high in caffeine) can also cause palpitations.

Can palpitations cause arrhythmia?

No, palpitations do not cause arrhythmia but may sometimes indicate that an arrhythmia is present.

How to tell the difference between AFib and heart palpitations?

In the case of heart palpitations, even though the heart flutters, the fluttering and contracting of the heart muscle is not in an erratic pattern, while in atrial fibrillation (AFib) the heart actually beats in an irregular and erratic manner.

When should I worry about palpitations?

You should see a doctor if palpitations do not go away on their own after a short while and if you have other symptoms like chest pain or fainting.

Is it normal to have heart palpitations every day?

While this may be normal for some people, it is probably safer to check with your doctor if you are concerned about palpitations.

Is it OK to have palpitations sometimes?

Yes, for many people palpitations are benign and do not indicate a serious issue but it is wise to see a doctor if you are concerned.

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References :

[0]Mitchell, L. Brent. “Overview of arrhythmias”. Merckmanuals. Merck & Co., 2022, https://www.msdmanuals.com/professional/cardiovascular-disorders/overview-of-arrhythmias-and-conduction-disorders/overview-of-arrhythmias

[1]Scott, Paul A., et al. "Impact of prolonged implantable cardioverter-defibrillator arrhythmia detection times on outcomes: a meta-analysis." Heart Rhythm 11.5 (2014): 828-835.

[2]Thompson, Andrea D. and Michael J. Shea. “Palpitations”. Merckmanuals. Merck & Co., 2022, https://www.msdmanuals.com/professional/cardiovascular-disorders/symptoms-of-cardiovascular-disorders/palpitations#

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