Waking up in the middle of the night with a thumping heart may be caused by physiological factors, or by pathological factors, such as tachyarrhythmia, hyperthyroidism, etc., which need to be dealt with according to the different situations by choosing general treatment, medication and surgery. 1. Physiological factors: some patients may be nervous before sleep, emotional excitement, drink strong tea, coffee, etc., after sleep, the body is still in a state of excitement, sympathetic nervous tension is higher, easy to wake up at night, waking up in the middle of the night, the heart thumping, in this case, it is recommended to improve the habits of life in a timely manner, and in general, can be relieved. 2. Pathologic factors: (1) Tachyarrhythmia: some patients may have tachyarrhythmia, such as paroxysmal supraventricular tachycardia, atrial tachycardia, etc., which can be relieved by applying cold water to the face, holding the breath, inverting, pressing on the eyeballs, and intermittent pressure on the unilateral carotid sinus. Do not press both carotid sinuses at the same time to avoid danger. If the condition is recurring need to follow the doctor’s instructions to take medication, such as metoprolol, bisoprolol and so on. If the condition still exists after oral medication, cardiac catheter ablation is recommended. (2) Hyperthyroidism: Some patients may have hyperthyroidism, which requires oral medications such as propylthiouracil and methimazole. If the patient repeatedly woke up in the middle of the night heart thumping, it is recommended to go to the hospital as soon as possible, after clarifying the cause of the disease, according to the doctor’s instructions for targeted treatment.