Cardiac Ectopic Beats
What is It?
Cardiac ectopic beats, also called premature beats, are extra heartbeats that interrupt the heart’s normal rhythm. They result in a premature beat often followed by a pause before the next beat, which feels like a ‘skipped’ heartbeat. There are two main types: premature atrial contractions (PACs), which originate in the upper chambers, and premature ventricular contractions (PVCs), which originate in the lower chambers. Ectopic beats are extremely common, occurring in the majority of healthy adults, and are the most common cause of palpitations. In most patients they are benign, but careful assessment is still required.
What are the symptoms?
If you have ectopic beats you may feel a ‘hiccup’ or ‘thump’ in the rhythm of your heart, a missed or skipped beat, or a fluttering sensation. They often occur during times of anxiety, stress or exercise, and may be triggered by smoking, alcohol, caffeine or certain foods. Some patients also feel faint, dizzy, or become aware of their heartbeat. Ectopic beats are more commonly noticed at night or while resting.
What are the causes?
At One Heart Centre our cardiologists screen for all causes of cardiac ectopic beats. Causes and triggers include:
- Lifestyle factors: Caffeine, alcohol, nicotine, stress, anxiety, fatigue and poor sleep.
- Electrolyte imbalances: Low potassium, magnesium or calcium levels.
- Medications: Certain decongestants, asthma inhalers and stimulants.
- Underlying conditions: Thyroid disease, high blood pressure, coronary artery disease, or cardiomyopathy in more frequent cases.
How is it investigated?
Most ectopic beats are harmless, but if they are frequent or persistent your One Heart Centre cardiologist will undertake tests to identify any underlying condition. Investigations typically include an ECG, echocardiogram, and a period of ambulatory ECG monitoring to assess the burden of ectopic beats. An exercise stress test or cardiac MRI may also be required in selected cases.
What are the treatments?
At One Heart Centre our cardiologists have post-fellowship training in managing cardiac ectopic beats and will provide a personalised treatment plan for your ectopic beats. Treatment options include:
- Reassurance and lifestyle modification: Reducing caffeine, alcohol and stress is often sufficient.
- Medical therapy: Beta-blockers or calcium channel blockers may be used to control symptoms.
- Catheter ablation: Occasionally required for symptomatic patients or when a high burden of ectopic beats is affecting heart function.
- Addressing underlying causes: Treating thyroid disease, electrolyte imbalances, or other contributing conditions.