What causes palpitations and episodes of passing out for a few years?

Hello,

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The probable cause in you is a cardiac arrhythmia. Firstly, were these episodes witnessed by others? And I guess there are tonic clonic movements as seen in seizures. Also, any precipitating events like stress, urination or passing stool, etc., this is to rule out the possibility of vasovagal syncopes. So, considering the likely possibility of cardiac arrhythmia and recurrent syncopes, there is an option of electrophysiological studies which can answer the cause. Otherwise, we will have to wait and watch until the episode of arrhythmia recurs and captured on ILR (implantable loop recorder). But, if you are having symptoms at present and there is nothing on ILR, then it cannot be a cardiac arrhythmia. So, if you are symptoms at present, then ILR should be interrogated, and if asymptomatic, then electrophysiological studies is an option. Otherwise, wait and watch. I hope this helps you and get back if you have any doubts.