Frequent pounding, fluttering, skipped beats or a continuously noticeable heartbeat can have many causes. Most palpitations are not dangerous, but persistent or worsening symptoms deserve proper evaluation to determine what the heart rhythm is actually doing.
“Constant heart palpitations” can mean a continuously noticeable heartbeat, frequent skipped or extra beats, repeated episodes throughout the day, or a sustained fast or irregular rhythm. Stress, lack of sleep, caffeine, nicotine, alcohol, medicines, anemia, thyroid disease and hormonal changes can contribute, while PACs, PVCs, atrial fibrillation, SVT and other arrhythmias are also possible. Because the sensation alone cannot identify the rhythm, palpitations that keep returning, become more frequent or last longer should be medically assessed.
What Are Constant Heart Palpitations?
Heart palpitations are sensations that make you unusually aware of your heartbeat. They may be felt in the chest, throat or neck.
People commonly describe them as:
- racing;
- fluttering;
- pounding or thumping;
- skipped beats;
- extra beats;
- an irregular heartbeat; or
- a heartbeat that simply feels unusually strong or noticeable.
The word constant is not a specific medical rhythm diagnosis. One person may mean that the sensation is present continuously, while another may mean they experience dozens or hundreds of noticeable beats during the day.
This difference is clinically important.
The sensation may occur during normal sinus rhythm, sinus tachycardia, premature atrial or ventricular beats, atrial fibrillation, SVT or another rhythm. The most reliable way to identify the cause is to record the electrical rhythm while the symptom is occurring.
See our broader guide to heart palpitation symptoms for the different sensations patients commonly experience.
What Causes Frequent or Persistent Heart Palpitations?
There are many possible causes, and more than one trigger can sometimes be present at the same time.
Stress and anxiety
Stress, anxiety and panic can increase heart rate and make normal or premature heartbeats much more noticeable.
Anxiety is one possible explanation, but persistent symptoms should not automatically be labeled as anxiety without considering other causes.
Caffeine and other stimulants
Coffee, energy drinks, nicotine and stimulant-containing medicines can make the heart beat faster or make ectopic beats more noticeable in susceptible people.
Read more about caffeine and heart palpitations .
Alcohol and recreational drugs
Alcohol can trigger palpitations or atrial fibrillation in susceptible individuals. Cocaine and amphetamines can cause dangerous tachycardias and other cardiovascular complications.
Lack of sleep
Sleep deprivation can increase sympathetic activity and make heartbeat sensations more noticeable. Caffeine used to compensate for poor sleep may further contribute in some people.
Exercise
Exercise normally raises heart rate. Some people notice palpitations during exercise or during the recovery period afterward.
Recurrent exercise-associated palpitations deserve particular attention, especially if dizziness, chest pain or fainting occurs.
Medicines
Some asthma medicines, stimulant medicines, decongestants containing pseudoephedrine and other medications may increase heart rate or trigger palpitations in susceptible individuals.
Do not stop prescribed medication without discussing it with the clinician who prescribed it.
Hyperthyroidism
Excess thyroid hormone can produce a fast heartbeat, pounding, tremor, heat intolerance and sometimes atrial fibrillation.
Learn more about thyroid disease and heart palpitations .
Anemia
Significant anemia can make the heart beat faster as the body tries to maintain oxygen delivery. Fatigue, weakness and shortness of breath may occur at the same time.
Hormonal changes
Palpitations can occur during pregnancy, menstruation or menopause. The clinical context matters because anemia, thyroid disease and cardiovascular conditions may produce similar symptoms.
Fever, illness or dehydration
Fever, significant dehydration and systemic illness can increase heart rate. Correcting the underlying problem often improves the associated sinus tachycardia.
Our main causes of heart palpitations guide provides a broader overview.
Which Heart Rhythm Problems Can Cause Persistent Palpitations?
Persistent symptoms do not automatically mean an arrhythmia is present, but several rhythms can produce frequent or sustained palpitations.
Premature atrial contractions (PACs)
PACs are early beats originating in the atria. They may feel like skipped beats, brief pauses, fluttering or a stronger beat afterward.
Occasional PACs are common, but frequent or changing symptoms may warrant rhythm documentation and assessment of the clinical context.
Premature ventricular contractions (PVCs)
PVCs originate in the ventricles and may feel like a skipped beat, pause or forceful thump.
Many PVCs in people without structural heart disease are benign. However, very frequent PVCs can occasionally impair heart function, so clinicians may quantify the PVC burden with ambulatory ECG monitoring and assess cardiac structure when appropriate.
The significance of premature beats depends on their frequency, ECG characteristics, symptoms, whether structural heart disease is present and whether heart function is affected. Rhythm monitoring is more useful than judging risk from the sensation alone.
Sinus tachycardia
Sinus tachycardia is a faster-than-usual rhythm generated by the heart’s normal pacemaker. It may occur with exercise, fever, dehydration, anemia, hyperthyroidism, anxiety, pain or other physiological stresses.
In this situation, treatment focuses primarily on identifying and correcting the underlying cause rather than simply slowing the heart.
Supraventricular tachycardia (SVT)
SVT often produces episodes of rapid regular heartbeat that begin and stop suddenly. Episodes can last minutes or longer and may recur frequently.
The specific type of SVT determines whether observation, medication, vagal maneuvers taught by a clinician or catheter ablation is appropriate.
Atrial fibrillation
Atrial fibrillation can produce an irregular, fast, fluttering or pounding heartbeat. It may occur in intermittent episodes or become persistent.
Some patients have few or no symptoms, so the sensation alone cannot reliably identify AF.
Other arrhythmias
Atrial flutter, atrial tachycardia, ventricular tachycardia and other rhythm disorders may also produce persistent or recurrent palpitations.
The treatment and risk differ substantially between these diagnoses, which is why documenting the rhythm is essential.
Important Correction: Persistent Palpitations Are Not Treated With One Standard Drug
The older version of this page listed adenosine, beta-blockers and calcium-channel blockers as general treatments for constant palpitations.
That approach is too broad.
Adenosine is used acutely for specific forms of regular supraventricular tachycardia. Beta-blockers, calcium-channel blockers, antiarrhythmic medicines, cardioversion and catheter ablation each have particular indications. Treatment should follow the actual rhythm diagnosis rather than the symptom “palpitations.”
How Do Doctors Evaluate Constant Heart Palpitations?
The goal is to determine whether the sensation represents a normal rhythm, premature beats, sinus tachycardia or another arrhythmia and whether an underlying medical or structural problem is present.
Medical history
Your clinician may ask:
- when the palpitations started;
- whether they are truly continuous or occur in repeated episodes;
- how long individual episodes last;
- whether the rhythm feels regular or irregular;
- whether it begins and stops suddenly or gradually;
- whether symptoms occur during exercise or at rest;
- whether caffeine, alcohol, nicotine or medicines are involved;
- whether you have chest pain, dizziness, fainting or breathlessness;
- whether you have known heart disease; and
- whether there is a family history of inherited heart disease or unexplained sudden death.
Physical examination and pulse
Your clinician may assess heart rate and rhythm, blood pressure, cardiac examination findings and signs suggesting thyroid disease, anemia, fluid problems or other underlying conditions.
12-lead ECG
An electrocardiogram records the electrical activity of the heart and is one of the first investigations when an arrhythmia is suspected.
If the palpitation is occurring during the ECG, the test may immediately reveal the rhythm.
If the symptoms stop before the ECG is recorded, the tracing may be normal. Longer monitoring can therefore be more useful when palpitations recur.
Blood tests
Depending on the history and examination, your clinician may consider tests for:
- anemia;
- thyroid dysfunction;
- significant electrolyte abnormalities; and
- other medical conditions suggested by your symptoms.
Echocardiogram
An echocardiogram may be appropriate when structural heart disease, cardiomyopathy, valve disease or very frequent ventricular ectopy is suspected.
Exercise testing
If palpitations consistently occur during exercise, exercise testing or rhythm monitoring during activity may sometimes be appropriate.
See our dedicated guide to heart palpitations after exercise .
Which Heart Monitor Is Used for Frequent Palpitations?
The monitoring device should generally be matched to how often the symptoms occur.
Holter monitor
A Holter continuously records the ECG, commonly for 24 hours or longer. It is particularly useful when symptoms occur every day.
Patch monitor
Adhesive ECG patches can provide longer continuous monitoring and may be useful when symptoms occur often but not necessarily every day.
Event recorder
An event monitor can be used over a longer period when episodes are less frequent. Some devices activate automatically when they detect an abnormal rhythm.
Implantable loop recorder
In selected patients with infrequent but potentially serious symptoms, such as unexplained recurrent fainting, an implantable loop recorder may provide very long-term rhythm monitoring.
Keeping a symptom diary is useful because the time of each palpitation can be compared with the recorded ECG.
If the monitor shows normal rhythm during the exact sensation, that information is also valuable.
How Are Persistent Heart Palpitations Treated?
Treatment depends on the cause.
If there is no dangerous rhythm disorder
If testing is reassuring, management may focus on reducing triggers that clearly affect the individual.
This may include:
- reducing excessive caffeine;
- avoiding nicotine;
- avoiding recreational stimulants;
- limiting alcohol if it repeatedly triggers symptoms;
- getting adequate sleep;
- maintaining appropriate hydration;
- managing stress; and
- reviewing medicines with a clinician or pharmacist.
Relaxation techniques may help when stress increases symptom awareness, but they should not be presented as treatment for an unknown arrhythmia.
If an underlying medical condition is found
Treatment may focus on conditions such as anemia, thyroid disease, fever, dehydration or another identified medical cause.
If an arrhythmia is documented
Management depends on the exact rhythm and may include:
- observation;
- medication;
- electrical cardioversion in selected situations;
- catheter ablation;
- treatment of structural heart disease; or
- other rhythm-specific therapy.
Atrial fibrillation management may also require assessment of stroke risk and whether anticoagulation is indicated.
What about Wolff-Parkinson-White syndrome?
Wolff-Parkinson-White syndrome involves an extra electrical pathway capable of participating in rapid heart rhythms.
In appropriate patients with symptomatic recurrent tachycardia, catheter ablation can eliminate the accessory pathway. Ablation uses energy such as radiofrequency heat or cryotherapy to create a small area of scar that blocks abnormal electrical conduction.
It is not performed with “high-frequency ultrasound,” as described in the older version of this article.
Dr. Albana’s Note
When someone tells me their palpitations are “constant,” my first question is what constant actually means. Are they feeling every heartbeat all day, repeated skipped beats, or episodes when the heart suddenly races for several minutes? I also ask about the pulse, exercise, caffeine, medications, dizziness and other symptoms. That distinction helps determine which tests are useful. When the episodes recur frequently, recording the rhythm during the symptom is usually far more informative than trying to diagnose it from the sensation alone.
When Should You Make a Medical Appointment?
Arrange medical evaluation when palpitations:
- keep coming back;
- are happening more often;
- last longer than a few minutes repeatedly;
- feel almost continuous;
- are persistently fast or markedly irregular;
- occur during exercise;
- repeatedly cause dizziness or unusual weakness;
- started after beginning or changing a medicine;
- occur in someone with known heart disease; or
- occur with a concerning family history of inherited cardiac disease or unexplained sudden death.
If dizziness is prominent, see dizziness and heart palpitations .
If weakness accompanies the episodes, see heart palpitations and weakness .
Urgent Warning Signs
Seek urgent or emergency medical care if ongoing palpitations occur with:
- chest pain, pressure or significant tightness;
- fainting or loss of consciousness;
- collapse;
- severe shortness of breath;
- severe dizziness or near-fainting;
- a sustained very rapid heartbeat while feeling seriously unwell;
- new severe weakness; or
- rapidly worsening symptoms.
Significant chest pain with palpitations should not be watched at home while waiting to see if relaxation or hydration fixes it.
See our chest pain and heart palpitations guide for additional education, but seek urgent medical care first when emergency warning signs are present.
Most Asked Questions
Are constant heart palpitations dangerous?
Not necessarily. Frequent palpitations may come from benign premature beats, stress, stimulants or other non-dangerous causes. However, persistent symptoms can also occur with arrhythmias or medical conditions that need treatment, so recurrent or worsening palpitations should be evaluated.
Why am I having heart palpitations all day?
Possibilities include increased heartbeat awareness, frequent PACs or PVCs, sinus tachycardia, stress, caffeine, nicotine, medication effects, anemia, thyroid disease or another arrhythmia. A symptom description alone usually cannot determine which is responsible.
Can PVCs happen all day?
Yes. Some people have frequent PVCs throughout the day. Many PVCs are benign, but very frequent ventricular ectopy may warrant Holter monitoring to quantify the burden and, in selected patients, echocardiography or additional testing to assess heart structure and function.
Can anxiety cause palpitations every day?
Anxiety can cause frequent heartbeat awareness, racing or pounding. However, persistent palpitations should not automatically be attributed to anxiety before other relevant medical and cardiac causes have been considered.
Can thyroid problems cause constant palpitations?
Yes. Hyperthyroidism can increase heart rate and can sometimes contribute to arrhythmias such as atrial fibrillation. Thyroid testing may be appropriate when other symptoms or the clinical history suggest thyroid dysfunction.
Can anemia cause frequent heart palpitations?
Significant anemia can produce a faster heartbeat and palpitations because the cardiovascular system is compensating for reduced oxygen-carrying capacity. Fatigue, weakness or shortness of breath may occur at the same time.
Can a normal ECG rule out the cause of constant palpitations?
Not always. If the abnormal rhythm is not happening during the short ECG, the tracing may be normal. A Holter, patch or event recorder may be needed to capture intermittent symptoms.
Which heart monitor is best if I get palpitations every day?
A continuous Holter or similar ambulatory ECG monitor is commonly useful when symptoms occur daily. Longer patch or event monitors may be preferred when symptoms occur less frequently. Your clinician chooses the device based on symptom frequency and clinical risk.
Do constant palpitations need medication?
Not automatically. Treatment depends on the rhythm and underlying cause. Some patients need only trigger reduction or treatment of a non-cardiac condition, while documented arrhythmias may require medicines, cardioversion, ablation or other rhythm-specific treatment.
Can frequent palpitations weaken the heart?
The sensation itself does not weaken the heart. However, certain sustained fast arrhythmias and, in some people, a high burden of PVCs can contribute to impaired heart function. This is one reason frequent documented ectopy or persistent tachycardia may require further evaluation.
Related Heart Palpitation Guides
Medical References
- American Heart Association. How Serious Are Heart Palpitations? Causes, Symptoms and When to Worry. Published February 9, 2026. American Heart Association .
- American Heart Association. Symptoms, Diagnosis and Monitoring of Arrhythmia. Last reviewed October 2024. American Heart Association .
- American Heart Association. Common Tests for Arrhythmia. American Heart Association .
- NHS. Heart Palpitations. Last reviewed March 17, 2026. NHS .
- Mayo Clinic. Heart Palpitations: Symptoms and Causes. Mayo Clinic .
- Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelines for the Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death. European Heart Journal. 2022;43:3997-4126. European Society of Cardiology .
- Brugada J, Katritsis DG, Arbelo E, et al. 2019 ESC Guidelines for the Management of Patients With Supraventricular Tachycardia. European Heart Journal. 2020;41:655-720. European Society of Cardiology .
- Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation. Circulation. 2024. American Heart Association .
- Mayo Clinic. Wolff-Parkinson-White Syndrome: Diagnosis and Treatment. Updated 2026. Mayo Clinic .
About the Medical Team
Dr. Albana Greca, MBBS, MMedSc
Family Physician / General Practitioner
Dr. Albana Greca has more than 20 years of experience in primary care, general medicine, chronic disease management, prevention, patient education and digital health.
Dr. Benard Shehu, MBBS, MS
Cardiologist
Dr. Benard Shehu has more than 19 years of cardiovascular experience, including clinical experience relevant to arrhythmias and cardiovascular disease.