What is heart palpitations?
Palpitations describe an unusual awareness of the heartbeat — racing, pounding, fluttering or missed beats. They are extremely common and usually benign: ectopic (extra) beats, stress, caffeine, alcohol, poor sleep and hormonal changes account for most cases. Sometimes, however, palpitations reflect an underlying rhythm disorder such as supraventricular tachycardia or atrial fibrillation, or occasionally a thyroid or anaemia problem, which is why persistent or troublesome palpitations deserve assessment — particularly if they come with blackouts, chest pain or breathlessness.
The challenge is catching the rhythm during an episode. Assessment combines a history, blood tests and a resting ECG with ambulatory monitoring — a wearable recorder worn for 24 hours to two weeks, or longer-term patch and loop recorders for infrequent episodes.
Common symptoms
- A racing or pounding heartbeat
- Fluttering sensations in the chest
- The feeling of skipped or extra beats
- A thumping awareness of the heartbeat at rest or in bed
- Episodes with dizziness or light-headedness
- Occasionally, associated chest discomfort or breathlessness
How long will you wait?
Routine NHS palpitations pathways are slowed mainly by diagnostics — waits of two to three months or more for ambulatory heart monitors and echocardiograms are common — so reaching a firm diagnosis frequently takes several months from GP referral.
Privately, you can typically see a cardiologist within 3–7 days, with ECG, ambulatory monitoring and an echocardiogram completed within 1–2 weeks.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Reassurance and lifestyle changes. Once serious causes are excluded, cutting caffeine and alcohol, improving sleep and managing stress often settle benign ectopic beats.
- Treating underlying causes. Correcting thyroid problems, anaemia or medication side effects resolves palpitations driven by them.
- Beta-blockers. Reduce the frequency and intensity of ectopic beats and rate-related palpitations when symptoms are intrusive.
- Catheter ablation. A curative keyhole procedure for confirmed rhythm disorders such as SVT or very frequent troublesome ectopics.
What does private treatment cost?
As a guide, a private assessment with consultation, ECG and a 24–48-hour monitor typically costs £500–£900, with an echocardiogram adding £300–£500 if needed.
Does health insurance cover heart palpitations?
Investigation of new palpitations is well covered by private medical insurance — consultations, monitors and echocardiography are standard eligible diagnostics, and treatment such as ablation for a confirmed arrhythmia is usually covered too. If a chronic condition like atrial fibrillation is diagnosed, ongoing drugs and monitoring then fall outside cover under chronic-condition rules. Palpitations investigated before you took out the policy would count as pre-existing.
Frequently asked questions
When should I worry about palpitations?
Seek prompt medical attention if palpitations come with fainting or near-fainting, chest pain, severe breathlessness, or occur during exercise — and urgent same-day help for a sustained very fast heartbeat that will not settle. Also mention a family history of sudden cardiac death to your doctor. Isolated fluttering or occasional missed beats at rest, while unsettling, are usually benign ectopics.
What are ectopic beats and are they dangerous?
Ectopics are early extra heartbeats followed by a brief pause, felt as a skip or thud. Almost everyone has them, and in a structurally normal heart occasional ectopics are harmless — reassurance, less caffeine and better sleep are usually the only treatment needed. Very frequent ectopics, or ectopics with an abnormal ECG or echo, warrant specialist review, and effective treatments exist including beta-blockers and ablation.
Why do I need to wear a heart monitor?
Because a normal resting ECG cannot exclude an intermittent rhythm problem — the abnormality has to be captured while it is happening. A wearable monitor records every heartbeat for 24 hours up to two weeks; if your episodes are rarer still, small patch recorders or an implantable loop recorder can watch for months. Correlating your symptoms with the recording is what secures the diagnosis.