When heart rhythm problems strike, the first place many patients turn is not the clinic waiting room but a search engine. A questionnaire survey of adults attending an outpatient arrhythmia clinic at the University Hospital Zurich in Switzerland found that 65.2 percent of participants had sought health-related information on the internet. The study, an exploratory cross-sectional survey conducted at the Department of Cardiology between October 2018 and March 2019, offers a detailed snapshot of how people with known or suspected cardiac arrhythmias gather medical information online, and what they do with what they find.

The research team recruited 112 consecutive adult participants who were awaiting a scheduled outpatient consultation for a known or suspected cardiac arrhythmia. Each person completed an anonymous, self-administered questionnaire before their appointment. The instrument covered sociodemographic and clinical characteristics, general and work-related internet use, the devices people used to get online, their use of health apps and wearable devices, and their health-related internet information-seeking behaviour. It also asked about non-digital information sources, the perceived differences between information found online and information given by physicians, and the perceived influence of online material on choices of physician or treatment centre.

The headline figure was that 73 of the 112 participants, or 65.2 percent, reported having sought health-related information online. Participants who searched online tended to be relatively young, with a mean age of 49.7 years among those who sought information, and vocational education was the most frequently represented educational category in this group, at 37 percent. The average time spent searching for health-related information was 3.8 hours per month. The most commonly reported reasons for going online were convenience, access to comprehensive information, the rapid availability of answers, and the chance to gain an initial overview of the condition.

Internet habits at work appeared to matter. Health-related internet information-seeking was associated with the frequency of work-related internet use, with a p value of 0.01. Among participants who used the internet daily for work, 76.3 percent, or 45 of 59, sought health information online. That compared with 58.6 percent, or 17 of 29, of those who used the internet occasionally for work, and 43.5 percent, or 10 of 23, of those who did not use it for work at all. Mobile phones were the most frequently reported devices for internet access, and 33 participants, or 29.5 percent, reported using health-related apps, wearable devices, or both.

One of the more striking exploratory comparisons involved occupation. None of the nine participants working as healthcare professionals reported seeking online health information, compared with 73 of the 103 participants in other occupations, a difference that reached a Fisher’s exact test p value below 0.0001. The authors caution, however, that the study conducted multiple exploratory analyses without multivariable adjustment or correction for multiple comparisons, and that small occupational subgroups, including healthcare professionals, limit the precision of such comparisons. All inferential findings should be regarded as hypothesis-generating rather than definitive.

The survey also revealed how information needs shift across the patient journey. Before diagnosis, participants most commonly searched for treatment options related to their symptoms, followed by information on the possible causes and significance of those symptoms. Once a diagnosis had been established, they mainly sought further information about the diagnosed cardiac arrhythmia and the treatment options available. Search engines were the primary access point in both periods, and participants generally consulted multiple websites rather than relying on a single source. More participants reported seeking online information after diagnosis than before, and they also reported spending more time searching after their diagnosis had been made.

The consequences of searching also differed between the two periods. Before diagnosis, more than half of participants reported that information found online prompted them to consult their general practitioner. After diagnosis, participants primarily used online information to better understand what their physician had told them, followed by keeping up to date with their condition and seeking additional information out of personal interest. Fewer than one in five reported encountering information that differed from the advice they had received from their physician. Among participants who did not search online, more than half reported consulting a physician instead at symptom onset, while roughly one fifth said internet access had not been available at the time. After diagnosis, the most frequent reason for not searching was that the physician had already provided the information required.

Perhaps the most reassuring finding concerns decision-making. Among 106 participants who answered the question on factors influencing their choice of physician or treatment centre, only 7, or 6.6 percent, reported that online health information had influenced that choice. Some 65 participants, or 61.3 percent, reported no influence, and 34, or 32.1 percent, cited recommendations from family or friends. Overall, 86 of 112 participants, or 76.8 percent, reported being satisfied with both the information they received and their treatment. Among the 15 participants who were not fully satisfied, 7, or 46.7 percent, reported seeking additional online health information. When asked about perceived usefulness, 22 of 110 participants with valid responses, or 20.0 percent, rated online information as not helpful or only slightly helpful, 21, or 19.1 percent, regarded it as complementary to a physician consultation, and just 2, or 1.8 percent, considered it more useful than a consultation. Of 63 participants for whom the question applied, 44, or 69.8 percent, reported not feeling unsettled by their online searches, while 19, or 30.2 percent, did feel unsettled, and 10 of those discussed their concerns with their physician.

Physicians remained central throughout. Four out of five participants reported relying on non-digital information sources, and physicians were the most frequent source of information. More than half of participants perceived non-digital sources as more valuable than online health information. The authors conclude that, in this single-centre sample, online health information appeared to support understanding of the cardiac condition and to complement information provided by healthcare professionals rather than replace professional medical advice. They emphasise the importance of helping patients critically appraise online health information and guiding them towards reliable digital resources, noting that prior to diagnosis, online searching often prompted people to seek professional evaluation rather than replace it.

The study’s limitations are considerable and the authors are candid about them. The cross-sectional design precludes causal conclusions, and questions about information-seeking before and after diagnosis were based on retrospective self-report rather than longitudinal follow-up. The questionnaire was developed specifically for this study, was not formally validated, and underwent no pilot testing or test-retest reliability assessment. The sample size was determined pragmatically, with no formal power calculation, and recruitment at a single tertiary arrhythmia referral centre may have introduced selection bias that limits generalisability. Data were collected in 2018 and 2019, before generative AI-based health-information tools were widely available, so contemporary patterns may differ. The authors argue the findings provide a useful pre-generative-AI baseline, and call for future multicentre studies using validated instruments to examine how social media and AI-based tools are reshaping information-seeking. The complete dataset and questionnaire materials are publicly available on the Zenodo open-access repository.

Subject of Research: Online health information-seeking among patients with cardiac arrhythmias

Article Title: Health-related internet information-seeking behaviour among patients with known or suspected cardiac arrhythmias: an exploratory cross-sectional questionnaire survey

Article References: Borges Antunes, S., & Duru, F. (2026). Health-related internet information-seeking behaviour among patients with known or suspected cardiac arrhythmias: an exploratory cross-sectional questionnaire survey. BMC Digital Health, 4(1), Article 62. https://doi.org/10.1186/s44247-026-00294-5

Image Credits: AI Generated

DOI: 10.1186/s44247-026-00294-5

Keywords: cardiac arrhythmias, online health information, patient survey, digital health, health literacy, physician-patient communication, cross-sectional study, University Hospital Zurich, internet use, shared decision-making, patient education, generative AI