AIMS: Despite increasing prevalence, the general population lacks knowledge regarding diagnosis, implications, and management of cardiac arrhythmias (CA). This study aims to assess public perception of CA and identify knowledge gaps. METHODS AND RESULTS: The 36-item PULSE survey was disseminated via social media to the general population and conducted under the auspices of the European Heart Rhythm Association Scientific Initiatives Committee (EHRA SIC) with EHRA patient committee support. Among 3924 participants (2177 healthy, 1747 with previously diagnosed CA; 59% female, 90% European), 81% reported fear of CA. Females were more likely to be 'very' or 'moderately afraid' than males [odds ratio (OR) 1.159 (1.005, 1.337), P = 0.046]. While most recognized complications of CA-heart failure (82%), stroke (80%), and death (75%)-43% were unaware that CA can be asymptomatic. Those with cardiopulmonary resuscitation (CPR) training in the past 5 years were 2.6 times and 4.7 times more confident identifying sudden cardiac death and initiating CPR (P < 0.001). Confidence was lower in retired participants [OR 0.574 (0.499, 0.660), P < 0.001] and Southern Europeans [OR 0.703 (0.600, 0.824), P < 0.001]. Without CPR training, only 15% felt confident initiating CPR. Among CA participants, 28% reported severe to disabling daily symptoms. Males were more often asymptomatic (20% vs. 9%, P < 0.001). Treatment rates were comparable between sex categories (81% vs. 79%, P = 0.413). Interdisciplinary shared decision-making processes were reported by 4%. Notably, 1 in 10 CA cases was self-diagnosed using a wearable device, and 30% of CA participants used smartwatches for self-monitoring. CONCLUSION: Significant knowledge gaps regarding CA exist in the general population. Targeted educational initiatives could be a viable tool to enhance public knowledge, confidence in detecting and managing arrhythmias, particularly for women, who experience greater fear and symptom severity despite similar treatment rates.

3rd Department of Cardiology Medical University of Silesia Katowice 40 635 Poland

Arrhythmia and Robotic Electrophysiology Unit La Paz University Hospital Madrid Spain

Arrhythmia Unit Vall d'Hebron University Hospital Barcelona 08035 Spain

ASKLEPIOS proresearch Institute Lohmühlenstrasse 5 20099 Hamburg Germany

Assistance Publique Hôpitaux de Marseille Centre Hospitalier Universitaire La Timone Service de Cardiologie Marseille France

C2VN Aix Marseille Université Marseille France

Cardioangiologic Center Bethanien Frankfurt am Main Germany

Cardiovascular Research Institute Mater Private Hospital and the Royal College of Surgeons in Ireland Eccles Street Dublin 7 Ireland

Clinic for Cardiology University Clinical Centre Kragujevac Kragujevac Serbia

Department for Internal Medicine Faculty of Medical Sciences University of Kragujevac Kragujevac Serbia

Department of Cardiology and Intensive Care Medicine Asklepios Hospital St Georg Lohmühlenstrasse 5 20099 Hamburg Germany

Department of Cardiology Cardiovascular Research Institute Maastricht Maastricht University Medical Centre Maastricht The Netherlands

Department of Cardiology Hospital Sta Cruz Lisboa Portugal

Department of Cardiology Karolinska University Hospital Stockholm Sweden

Department of Cardiology St Antonius Hospital Nieuwegein The Netherlands

Department of Cardiology Unidade Local de Saúde do Alto Ave Guimarães Portugal

Department of Cardiology University Hospital Giessen Rudolf Buchheim Straße 8 35392 Giessen Germany

Department of Heart and Lung Diseases Karolinska Institute Huddinge Stockholm Sweden

Department of Public Health and Clinical Medicine Umeå University Umea Sweden

Department of Rhythmology University Heart Center Lübeck University Hospital Schleswig Holstein Lübeck Germany

Division of Cardiology Department of Medical Sciences 'Città della Salute e della Scienza di Torino' Hospital University of Turin Turin Italy

Division of Cardiology Medical University of Graz Graz Austria

European Society of Cardiology Patient Forum Sophia Antipolis France

Faculty of Health and Medical Sciences Department of Biomedical Sciences University of Copenhagen Copenhagen Denmark

German Center for Cardiovascular Research Partner Site Hamburg Kiel Lübeck Lübeck Germany

Heart Rhythm Centre Royal Brompton and Harefield Hospitals Guy's and St Thomas' NHS Foundation Trust Hill End Road Harefield London UB9 6JH UK

Interventional Cardiac Electrophysiology Group International Clinical Research Center St Anne's University Hospital Brno Brno 602 00 Czech Republic

Ordensklinikum Linz Elisabethinen Department of Cardiology Linz Austria

School of Biomedical Engineering and Imaging Sciences Faculty of Life Sciences and Medicine King's College London London UK

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