Has your heart ever suddenly felt as though it was pounding wildly, as if it had lost its normal rhythm?

It’s not uncommon—but is it a dangerous sign of a stroke or even impending sudden death? In an episode of “Health 1+1” on NTD, a sister outlet of The Epoch Times, cardiologist Liu Chung-Pin said that abnormal heartbeat situations require immediate medical attention. He also offered self-management techniques to use when palpitations occur.

Heart palpitations, Liu said, refer primarily to a clearly felt abnormal heartbeat—uneven speed, and rapid or erratic beating. Indiscriminately referring to chest pain, chest tightness, or chest constriction can interfere with diagnosis and lead to incorrect assessment by medical personnel.

When communicating with a doctor, people should specifically describe the sensations in the heart, including whether they are accompanied by dizziness, shortness of breath, or chest pain. Such details are often crucial for diagnosis.

3 Types of Heartbeat Abnormalities

The heartbeat is the rhythm of life. The human heart beats approximately 100,000 times a day, pumping blood throughout the body. Under normal circumstances, we hardly feel the heartbeat. However, when there is an abnormality, the body often sends different signals, Liu said.

He summarized common heartbeat abnormalities into three main categories:

1. Persistent Abnormal Beating

Patients may report that their heartbeat is “constantly fast all day” or “beats for a few minutes and then stops.” Doctors usually diagnose arrhythmia for this type of symptom. Arrhythmia refers to irregular heartbeats, including rapid or slow rhythms or palpitations.

2. Transient Irregular Beats

Some patients experience symptoms that do not show up continuously, but rather as a sudden “one or two beats, and then it’s gone,” or a feeling of being “hit” in the chest before it disappears. These single or consecutive abnormal two to three beats are medically termed “premature beats.” Although brief, if they occur while driving or exercising, they can cause momentary disorientation and pose a potential danger.

3. Atypical Symptoms

Some patients may describe the sensations as “tightness,” “weirdness,” or “slight shortness of breath,” or family members may notice that an older person’s complexion has recently changed. These seemingly unrelated signs may stem from a heart rhythm disorder, affecting overall heart function.

Causes of Irregular Heartbeats

The pericardium and pericardial fluid surrounding the heart help lubricate it, reduce friction during pulsations, and protect it from impact. They act like a shock absorber, isolating the impact of the heartbeat, so under normal circumstances, we can barely feel our heart beating.

Liu said that people usually experience irregular heartbeats due to two main causes:

1. External Environmental and Physiological Factors

These are temporary stimuli and can usually be improved by adjusting lifestyle.

• Emotional Factors: Heart rate increases when you’re feeling tense and decreases when you’re relaxed.


• Lifestyle and Health Conditions: Insufficient sleep, fever, diarrhea, and other physical discomforts can all increase heart rate.


• Physical Environment: Sudden temperature changes can affect heart rate.


• Dietary Stimuli: Drinking too much coffee, strong tea, or eating spicy foods may trigger irregular heartbeats.

2. Abnormalities in the Cardiac Rhythm System

The heart has a sophisticated rhythm system that controls the regularity of the heartbeat, Liu said. When this system malfunctions, even if a patient is in a good mood, the heart may suddenly beat erratically. Such problems require professional diagnosis and treatment.

How Fast Is Considered Abnormal?

What is the standard for a “fast” heartbeat?

1. Absolute Standard: Generally, a heart rate exceeding 100 beats per minute (BPM) at rest is considered fast and requires special attention.

2. Relative Standard: If the rate is more than 30 BPM above a person’s normal baseline heart rate, it can cause discomfort. For example, someone with a normal heart rate of 60 BPM might feel uncomfortable if it suddenly increases to 90 BPM, even if it is still below the absolute standard of 100 BPM. Such an increase is considered significant.

It is necessary to distinguish between physiological acceleration and pathological arrhythmia, Liu said. The former, such as during exercise or fever, occurs when the heart is operating under a normal electrical conduction system with a normal contraction pattern.

The latter is caused by abnormal electrical discharges in an abnormal location within the heart, leading to irregular electrical conduction and uncoordinated heart contractions. This abnormality not only reduces heart function but can also be life-threatening in severe cases.

The 2 Most Deadly Arrhythmias

A racing heart might feel like a pending stroke or cardiac arrest. Although most arrhythmias are benign, malignant arrhythmias are a major cause of sudden death—and should be taken seriously, Liu said. In particular, the following two types require close attention:

1. Atrial Fibrillation: In atrial fibrillation, the atria cannot contract effectively, and blood can easily become stagnated within the atria, forming blood clots. If a blood clot breaks off and travels to the brain, it can cause a stroke. Some people with atrial fibrillation are completely asymptomatic, experiencing no obvious symptoms and unaware of their stroke risk.

2. Ventricular Tachycardia: Ventricular tachycardia refers to insufficient blood pumping by the heart due to excessively rapid ventricular contractions. It is the most common malignant arrhythmia and can be life-threatening within a short time.

Both of these arrhythmias require an electrocardiogram (ECG) for diagnosis, Liu said. It is almost impossible for people to determine the specific arrhythmia they have based solely on the sensation of their heartbeat. Therefore, if you clearly feel your heart beating irregularly, do not self-diagnose or ignore it; seek medical attention immediately.

3 Key Indicators for Seeking Medical Attention

With irregular heartbeats, Liu recommends seeking medical attention immediately if any of the following occur:

1. Duration of More Than 30 seconds: If an irregular or rapid heartbeat lasts longer than 30 seconds, it may indicate a more persistent and serious arrhythmia.

2. Frequent Episodes: If an increased or irregular heartbeat only occurs once every few months or is related to a specific event (such as fever or extreme stress), observation is still necessary. However, if it recurs several times within a week, it may indicate that the body has formed a fixed pattern of abnormal electrical discharges.

3. Severe Accompanying Symptoms: Symptoms such as dizziness, chest tightness, chest pain, shortness of breath, or other apparent discomfort during a palpitation may indicate that the arrhythmia has seriously compromised blood circulation or heart function.

If you live in a remote or suburban area with limited medical resources or are about to embark on a long-distance trip—such as by plane or boat—seek medical attention before departure if you feel your heartbeat is unstable.

A 3-Step Approach to Self-Help During a Palpitation Attack

When palpitation strikes, what should we do to help ourselves? According to Liu, the following steps may help stabilize your heartbeat and alleviate immediate danger:

1. Sit or Lie Down Immediately

During a palpitation, the heart’s output function declines, which may affect blood circulation and easily lead to dizziness and unsteadiness. Immediately stop all activity and sit or lie down to rest to avoid falling and injuring yourself due to possible loss of consciousness.

2. Slow Your Breathing

Maintain steady, gentle breathing. Avoid rapid breathing, as this can trigger hyperventilation syndrome, further disrupting the nervous system and worsening the condition.

3. Stimulate the Parasympathetic Nervous System

Drink a glass of water or swallow saliva, which may help restore the balance of the autonomic nervous system, potentially stabilizing your heartbeat. Alternatively, you can gently inhale, then hold your breath for a few seconds, which also helps to activate the parasympathetic nervous system. However, stop immediately if you feel dizzy.

If the symptoms do not improve after trying all the above, or continue to deteriorate, seek medical help immediately.

Guidelines for Self-Recording During an Attack

Record the following information to help your doctor make the most accurate diagnosis:

1. Time and Context of the Attack

Write down the exact time of the attack and how long it lasted. It is also crucial to meticulously record what you were doing at that time—resting, just finished eating, exercising—and what you had eaten or drunk. These essential details help doctors determine the likely trigger. Liu recommends immediately recording this information using a mobile phone or pen and paper.

2. Heart Rate Measurements

Tracking your heart rate during an episode can provide valuable insight into what your heart is doing in real time and help guide an accurate diagnosis.

Use a Device: A blood pressure monitor, smartwatch, or pulse oximeter can help measure and record your heart rate.

Manual Measurement: If no devices are available to record your details, gently place your fingers on your neck or wrist to check your pulse.

Some smartwatches and wearable devices can record a simple electrocardiogram (ECG). However, factors such as physical activity and poor device contact can cause inaccurate data recording, Liu said. Therefore, it is essential to ensure the device is firmly pressed against dry skin while at rest to obtain more reliable readings.