Prevalence of Palpitations in the General Population
Palpitations are an extremely common symptom, affecting a substantial portion of the general population, though precise epidemiologic data on the symptom itself (rather than underlying arrhythmias) remains limited.
Epidemiologic Data on Underlying Arrhythmias
While comprehensive population-based data specifically on palpitations as a symptom is sparse, we can extrapolate from data on supraventricular tachycardia (SVT), one of the most common causes:
- SVT prevalence in the general population is 2.29 per 1,000 persons (approximately 0.2%) 1
- The incidence of paroxysmal SVT is 36 per 100,000 persons per year, with approximately 89,000 new cases annually and 570,000 persons living with paroxysmal SVT in the United States 1
- Atrial fibrillation affects an estimated 2.3 million people in North America and 4.5 million worldwide, accounting for approximately one-third of hospitalizations for cardiac rhythm disturbances 1
Clinical Presentation Frequency
The actual symptom of palpitations is far more common than documented arrhythmias:
- Palpitations are widely diffused in the general population, particularly in subjects with structural heart disease 2
- Palpitations are one of the most common reasons for medical consultation and tend to significantly worry patients, affecting their quality of life 3
- In cardiac clinic populations, palpitations are a very common presenting symptom associated with marked disability 4
Important Context on Etiology
When patients with palpitations are evaluated in secondary care settings:
- Only 34% have documented arrhythmias, 41% have extrasystoles, and 26% have awareness of normal sinus rhythm 4
- Most patients presenting with palpitations do not have serious underlying cardiovascular conditions, though concurrent psychological problems are common and persistent 4
- Palpitations are commonly described in the general population and are frequent presenting symptoms in all medical settings, often transient but can be persistent with considerable disability and distress 5
High-Risk Demographics
Certain populations have substantially elevated risk:
- Women have twice the risk of men of developing paroxysmal SVT 1
- Individuals >65 years of age have >5 times the risk of younger persons of developing paroxysmal SVT 1
- The incidence increases with age, with a five-fold greater risk in those aged ≥65 years compared to younger individuals 1
Clinical Significance
Despite being common, palpitations warrant appropriate evaluation:
- SVT is commonly a reason for emergency department and primary care physician visits but is infrequently the primary reason for hospital admission 1
- Recurrent palpitations impair quality of life and increase healthcare utilization 6
- Palpitations are associated with low mortality rates, but their impact on quality of life is substantial 6