Fast irregular heartbeat

Palpitations may feel like racing, fluttering, skipped beats, or pounding. Atrial fibrillation is one rhythm that can make the pulse fast and uneven, although an episode can also follow stress, fever, stimulants, dehydration, or another rhythm disturbance. Dizziness can occur when the heart does not pump steadily enough for the brain. A clinician may ask about onset, duration, triggers, alcohol, caffeine, thyroid symptoms, and heart history. The sensation alone cannot identify the rhythm.

Stop exertion and sit or lie somewhere safe. Check whether the pulse feels irregular and note the start time, associated symptoms, and anything that may have triggered it. Avoid driving, strenuous exercise, nicotine, and excess caffeine while symptoms continue. Arrange medical review for a first episode, repeated episodes, or a pulse that remains abnormal after rest. An electrocardiogram can record the rhythm, and longer monitoring may be considered when episodes come and go.

Call emergency services for chest pain, severe breathlessness, fainting, confusion, sudden weakness or numbness on one side, facial drooping, trouble speaking, or a sudden severe headache. These can signal a dangerous heart problem or stroke. Seek urgent advice for new persistent palpitations with marked dizziness or weakness. Do not stop prescribed anticoagulation management without medical guidance.

Could this be atrial fibrillation or another rhythm? Do I need an ECG or portable monitor? What is my stroke-risk assessment, and should anticoagulation be discussed?