A palpitation — a skipped, extra or irregular heartbeat — is a type of abnormal heart rhythm, or arrhythmia. It occurs when an electrical signal fires from the wrong place at the wrong time, causing the heart to beat out of rhythm.

Many people are unaware of minor irregular heartbeats, and even completely healthy people have extra or skipped heartbeats once in a while. Palpitations are more common as you age. Usually, these occasional arrhythmias are nothing to worry about. But in some cases, extra or irregular beats can cause bothersome symptoms or lead to other types of sustained, rapid heart rhythms.

What causes palpitations?

Occasional, harmless palpitations can have many causes:

  • Stress or anxiety
  • Strenuous activity
  • Extreme fatigue
  • Hormonal changes caused by pregnancy, menopause or menstruation
  • Low blood pressure
  • Caffeine
  • Nicotine
  • Alcohol
  • Stimulant medications, including pseudoephedrine (a decongestant)
  • Increasing age

However, some palpitations may be symptoms of a more serious condition, such as:

What are the symptoms of palpitations or an irregular heartbeat?

Many people experience palpitations (the feeling that their heart is momentarily racing or pounding), a skipped or extra beat or a fluttering or forceful beat.

When you feel a "skipped" beat, what you are probably experiencing is an early heartbeat. Because the heart contracts before the ventricles have had time to fill with blood, there is little or no blood pushed out to the body. Therefore you don't feel that contraction as a beat. The next beat will feel more forceful, as an extra volume of blood is then pushed out.

However, some symptoms are more serious. Consult with your doctor if you experience any of these:

  • Frequent palpitations
  • Fainting
  • Dizziness
  • Unusual sweating
  • Lightheadedness
  • Chest pains

Learn more about arrhythmias or visit the Johns Hopkins Electrophysiology and Arrhythmia Service.

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