Heartbeat is controlled by the autonomic nervous system. If nerve impulses are disrupted, the heart will continue beating, but at its own, usually slower rate. The most common form of palpitation—usually experienced at rest—is caused by ectopic heartbeats, when a premature beat is followed by an unusually long pause. This feels like a thumping or fluttering in the chest, and is not usually indicative of heart disease. It is caused by stimulants—for example large amounts of caffeine or heavy smoking. Palpitations with an irregular heartbeat may be symptomatic of heart disease. They may also be caused by an overactive thyroid gland, high fever, food allergy, and certain recreational drugs, such as amphetamines or cocaine. Palpitations may be a side-effect of some prescribed drugs, particularly those that regulate blood pressure, or they may be triggered by anxiety.

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