If you are choosing help with atrial fibrillation treatment, review how your palpitations were investigated, the stroke risk assessment and anticoagulation plan, the treatment options and their tradeoffs, the monitoring and follow up approach, and how care will coordinate with your primary doctor in the Theater District and across New York.
What are heart palpitations and why they matter
Heart palpitations feel like a fluttering, missed beat or rapid pounding in the chest. They are a symptom, not a diagnosis. Common causes range from benign premature beats to clinically important arrhythmias such as atrial fibrillation, and from non cardiac triggers such as anxiety, caffeine or thyroid disease.
Understanding the underlying cause matters because the treatment and the risk to your health vary widely. Atrial fibrillation increases stroke risk and often requires a structured plan that covers rhythm or rate control, anticoagulation decisions, and long term monitoring.
Key concepts to review before choosing help
- Confirmed diagnosis. Ask how your palpitations were identified as atrial fibrillation rather than another rhythm issue, and what tests were used.
- Stroke risk and anticoagulation. Review how your stroke risk is calculated and the reasoning behind any blood thinner recommendation.
- Treatment options and tradeoffs. Rate control, rhythm control, cardioversion, catheter ablation and medications each have benefits and limitations.
- Monitoring plan. Continuous or intermittent monitoring affects how we detect recurrences and adjust therapy.
- Care coordination. Good treatment works with your primary care doctor and other specialists, especially when you have diabetes, high blood pressure or a family history of heart disease.
How palpitations and atrial fibrillation are typically evaluated
We explain the typical evaluation so you know what to expect, and so you can compare providers on thoroughness rather than on promises.
- History and symptom pattern. When do palpitations occur, how long do they last, what provokes them and what relieves them.
- Physical exam and basic tests. Blood pressure, pulse exam, resting electrocardiogram and basic blood work including thyroid function.
- Ambulatory monitoring. Holter or event monitors track rhythms over days to weeks. Longer monitoring can reveal intermittent atrial fibrillation missed on short tests.
- Risk assessment. Stroke risk tools, evaluation of bleeding risk and assessment for underlying heart disease guide anticoagulation decisions.
- Imaging and advanced testing. Echocardiography and, when indicated, cardiac imaging to look for structural disease or clot risk.
Checklist to use when you compare providers
- Was atrial fibrillation confirmed by an ECG or documented monitor tracing?
- Did the provider calculate stroke risk and explain anticoagulation options?
- Were rhythm and rate control options explained with pros and cons for each?
- Is there a clear monitoring plan for recurrence and follow up?
- Will care be coordinated with your primary care doctor and any other specialists?
- Does the practice offer preventive cardiology services for long term risk reduction?
Common causes of palpitations to consider
When we evaluate palpitations we consider cardiac and non cardiac causes. Common cardiac causes include atrial fibrillation, supraventricular tachycardia and premature ventricular or atrial contractions. Non cardiac causes include anxiety, stimulants such as caffeine or alcohol, thyroid dysfunction, certain medications and electrolyte imbalance.
Where the cause is unclear, extended rhythm monitoring or targeted blood testing often provides the answer. At our center we combine careful history taking with the appropriate tests so we do not miss intermittent atrial fibrillation.
Comparing rate control and rhythm control
| Approach | When it is chosen | What it aims to do |
|---|---|---|
| Rate control | When symptoms are moderate and rhythm restoration is unlikely or carries higher risk | Keep the heart rate steady to relieve symptoms and reduce strain on the heart |
| Rhythm control | When symptoms are disabling, early in disease, or when maintaining normal rhythm is a priority | Restore and maintain normal rhythm by medication, cardioversion or ablation |
Pro tip: Bring copies of any ECGs or monitor reports, a list of current medications including supplements, and a short symptom diary showing when palpitations happen and what you were doing. That information speeds diagnosis and improves the quality of the treatment discussion.
What to expect from a specialist focused on prevention
As a preventive cardiology practice we focus on reducing your long term risk of heart attack, stroke and sudden cardiac death while treating atrial fibrillation. That means we balance immediate symptom control with measures that lower future risk, such as managing blood pressure, cholesterol and diabetes, and tailoring anticoagulation when appropriate.
Dr. Bradley Radwaner and our team use evidence based practices, advanced testing when needed, and individualized plans that coordinate with your primary care physician. We provide care to adults across Manhattan, the Bronx, Queens, Brooklyn, Westchester, Long Island, New Jersey and the greater New York metropolitan area.
When you should seek faster evaluation
Seek prompt evaluation if palpitations come with shortness of breath, chest pain, fainting or near fainting, or if you suddenly feel very weak. Those symptoms may indicate a higher risk rhythm problem or other urgent cardiac conditions and warrant rapid assessment.
Related services and resources
For detailed information on treatment choices, see our Atrial Fibrillation Treatment service page at Atrial Fibrillation Treatment. To read more about symptoms that accompany atrial fibrillation, visit our topic page on Atrial Fibrillation Symptoms. If you want to find our office locations and where we care for patients across the city region, see our locations and service area page.
Key takeaway
Before choosing help with atrial fibrillation treatment review how the diagnosis was confirmed, how stroke risk and anticoagulation are handled, the realistic benefits and tradeoffs of rhythm versus rate strategies, the monitoring plan, and how care will be coordinated with your primary doctor in the Theater District and across New York.
Frequently asked questions
How do you tell the difference between harmless palpitations and atrial fibrillation?
We start with a detailed history and a resting ECG. If an ECG does not show atrial fibrillation but symptoms continue, we use ambulatory monitoring such as a Holter or event monitor to capture intermittent episodes. Blood tests and imaging help rule out non cardiac causes.
Will I always need blood thinners if I have atrial fibrillation?
Not always. Anticoagulation depends on your individual stroke risk and bleeding risk. We calculate risk using accepted tools and discuss the benefits and risks before recommending blood thinner therapy.
What are the risks and benefits of catheter ablation?
Catheter ablation can reduce symptoms and reduce the need for long term antiarrhythmic drugs in many patients. It is a procedure with procedural risks that you should discuss in detail with a specialist. We explain likely outcomes and alternative strategies so you can make an informed choice.
How long should monitoring last to diagnose intermittent atrial fibrillation?
The monitoring duration depends on symptom frequency. For rare episodes longer monitoring increases the chance of detection. We choose the shortest test that will give a reliable answer for your pattern of palpitations.
Learn more and check reviews
Read patient reviews and directions on our Google Business Profile, and explore related pages about atrial fibrillation care and preventive cardiology on this site for more detail.
Atrial Fibrillation Symptoms | Atrial Fibrillation Treatment | Locations and service area