Most patients are unable to describe an initiating factor.
Palpitation during exercise suggests the involvement of the adrenergic system. Beta-blockers may be of use.
Palpitation at rest suggests vagal involvement. Vagolytics e.g. disopyramide may be of use.
Most patients have involvement of both adrenergic and vagal systems.
There is little clinical utility in detailed questioning about initiating factors.
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