An irregular heartbeat often announces itself with a fluttering, pounding, or racing sensation in your chest, or a feeling like your heart just skipped a beat. But not always. Some irregular heartbeats produce no noticeable symptoms at all and are only caught during routine medical tests or through wearable devices. Knowing what to feel for, both in your body and at your wrist, can help you figure out whether something is off.
What It Feels Like
The most common sensation is a flutter or pounding in your chest that feels distinctly different from your normal heartbeat. You might notice your heart racing even though you’re sitting still, or beating so slowly that you feel sluggish or lightheaded. Some people describe it as a “skipped beat,” which is usually a premature heartbeat followed by a brief pause before the next one lands harder than usual.
Beyond the chest, irregular heartbeats can cause shortness of breath, dizziness, unusual fatigue, sweating, or a wave of anxiety that seems to come from nowhere. Some types start and stop abruptly. One moment you’re fine, the next your heart is pounding at full speed, and then it snaps back to normal just as suddenly. That pattern is characteristic of a type called supraventricular tachycardia.
If you experience chest pain, fainting, or severe shortness of breath alongside a racing or irregular heartbeat, that combination needs emergency attention.
How to Check Your Pulse at Home
You can get useful information just by feeling your own pulse. Sit quietly for a few minutes first, then turn one hand palm-up. Place the tips of your index and middle fingers on the inside of your opposite wrist, in the groove between the wrist bone and the tendon on the thumb side. Press lightly until you feel each beat. Pressing too hard can actually block blood flow and give you a misleading reading.
Count beats for a full 60 seconds while watching a clock. A normal resting heart rate for adults falls between 60 and 100 beats per minute. A rate consistently above 100 at rest, or below 60 (if you’re not a trained athlete), is worth bringing up with a doctor. But the number alone isn’t the whole picture. Pay attention to the rhythm. The beats should feel evenly spaced, like a metronome. If you notice beats that come too early, long pauses between beats, or a rhythm that feels chaotic rather than steady, that’s what an irregular heartbeat actually feels like under your fingers.
You can also check your pulse at your neck by placing two fingertips in the groove next to your windpipe on one side. Never press both sides of your neck at the same time, as this can make you dizzy or faint.
When There Are No Symptoms at All
One of the tricky things about irregular heartbeats is that they can be completely silent. Atrial fibrillation, the most common type of recurrent arrhythmia (affecting more than 3 million people in the U.S.), frequently comes and goes without producing any noticeable symptoms. This matters because even “silent” atrial fibrillation is an independent risk factor for stroke.
These hidden episodes are often caught only through extended monitoring. A standard heart tracing done in a doctor’s office captures just a few seconds of activity, so a rhythm problem that comes and goes can easily be missed. That’s why prolonged monitoring over days or weeks is sometimes necessary to catch what a quick office test won’t.
What Smartwatches Can (and Can’t) Tell You
Consumer wearables have become surprisingly capable at flagging irregular rhythms. In a large study of Apple Watch users who received irregular pulse notifications, 84% of those alerts correctly identified atrial fibrillation. Fitbit devices performed even better in a confirmatory study, with 98.2% accuracy when an initial alert was followed up with a medical-grade recording. Across multiple analyses, smartwatches have shown 96% sensitivity and 94% specificity for detecting atrial fibrillation, putting them close to medical-grade devices.
That said, a smartwatch alert is a screening tool, not a diagnosis. It can prompt you to seek proper testing, but it can also miss rhythm problems that happen when the watch isn’t actively checking, or flag false alarms from motion or a loose fit.
How Doctors Confirm an Irregular Heartbeat
The first step is usually an electrocardiogram (ECG), a quick, painless test where small sticky sensors are placed on your chest to record your heart’s electrical activity. If the irregular rhythm is happening at that moment, the ECG will catch it. The problem is that many arrhythmias are intermittent.
For rhythms that come and go, the next step is a Holter monitor. This is a small wearable device, roughly the size of a deck of cards, connected to electrode patches on your chest. You wear it during your normal daily activities for one to two days while it continuously records every heartbeat. If a day or two isn’t long enough to catch the problem, an event monitor extends the window to several weeks. With an event monitor, you typically press a button when you feel symptoms, and the device captures the heart’s activity at that moment.
For episodes that are even more elusive, doctors sometimes use implantable loop recorders that sit just under the skin and can monitor heart rhythm for months or even years.
Why the Heart’s Rhythm Goes Wrong
Your heart runs on its own electrical system. A cluster of cells at the top of the heart generates an electrical signal that travels along a specific pathway, telling each chamber when to contract. An irregular heartbeat happens when that signal doesn’t get produced properly, doesn’t travel the right route, or both.
On the surface of every heart muscle cell are tiny pores called ion channels that create this electrical activity. Problems with these channels, or with the wiring that carries signals through the heart, lead to different types of rhythm disturbances. A malfunction at the top of the system (the heart’s natural pacemaker) can make the heart beat too slowly or too fast. A block in the middle relay station can prevent signals from reaching the lower chambers entirely. And problems in the branching pathways that carry signals to the left and right sides can cause the chambers to contract out of sync.
Common Triggers for Temporary Palpitations
Not every irregular heartbeat signals a serious problem. Many people experience temporary palpitations triggered by everyday factors: caffeine, alcohol, stress, spicy food, smoking, or pregnancy. If anxiety or stress is the trigger, practices like meditation, deep breathing, or yoga can reduce episodes. Cutting back on coffee or alcohol resolves palpitations for many people entirely.
These benign palpitations typically feel like a brief flutter or skipped beat and pass within seconds. They don’t cause fainting, chest pain, or prolonged episodes of rapid heart rate. If your palpitations consistently last longer than a few seconds, happen without an obvious trigger, or come with other symptoms, that pattern suggests something beyond a simple lifestyle trigger.
Who Is Most at Risk
The risk of developing an irregular heartbeat rises with age. High blood pressure, diabetes, a history of stroke, and buildup of fatty deposits in the arteries all increase the likelihood. Genetics play a role too. Up to 30% of people with atrial fibrillation who have no other identifiable cause have a family history of the condition. In some families, mutations in specific genes cause atrial fibrillation to run through generations in a dominant inheritance pattern, meaning a single copy of the altered gene from one parent is enough. More commonly, combinations of small genetic variations across more than two dozen genes nudge risk up without guaranteeing the condition will develop.
If you have several of these risk factors, paying closer attention to your heart rhythm through periodic pulse checks or a wearable device can help catch a problem early, particularly the silent type of atrial fibrillation that raises stroke risk without ever producing symptoms you’d notice on your own.