Waking up at night with a particularly fast heartbeat may be caused by physiologic and pathologic factors such as acute heart failure, hyperthyroidism, cardiomyopathy and other factors. It is recommended to consult a doctor in time, under the guidance of the doctor to clarify the cause of the disease and then treatment. 1. Physiological factors: common such as mental stress, late at night, etc. can lead to wake up at night, wake up fast heartbeat symptoms. 2. Pathologic factors: (1) heart failure: mainly due to overloading of the heart or myocardial pathology, which makes the pumping function of the heart impaired, the volume of blood discharged by the heart is not able to meet the body’s needs, which will appear at night time palpitations (rapid heartbeat, often accompanied by panic), shortness of breath, fatigue and other discomforts. It is necessary to consult the Cardiovascular Medicine Department immediately for treatment. (2) Hyperthyroidism: usually due to excessive thyroid hormones, which leads to accelerated metabolic activity of the body, palpitations, polyphagia, emaciation and other symptoms. You can follow the doctor’s advice to choose the medication such as formamidazole, prothioxythiophene and so on. 3. Myocarditis: usually caused by viral infection and other factors, patients may experience palpitations, shortness of breath and other discomforts. Waking up at night with a particularly fast heartbeat requires prompt medical attention and targeted treatment according to the cause.