Palpitations: When Are an ECG and Holter Monitor Needed?

Palpitations may feel like fast, irregular or forceful heartbeats. Stress, caffeine and lack of sleep can contribute, but heart rhythm disorders are another possibility.

Symptoms, causes and key details

An ECG records the rhythm at one moment. When episodes come and go, a 24–48-hour or longer Holter monitor may help connect symptoms with recorded rhythm.

Assessment and practical next steps

Note when episodes occur, their duration, pulse, medicines and caffeine intake. A clinician may consider blood count, thyroid testing or cardiology assessment.

When is urgent help needed?

Seek emergency care for palpitations with fainting, chest pain, severe breathlessness or altered awareness.

Frequently asked question

Does a normal ECG rule out arrhythmia?

No, intermittent disturbances may not occur during the recording.

This article provides general information, not a personal diagnosis or treatment.

Trusted information source: https://www.nhs.uk/conditions/heart-palpitations/