Check-Up: Ectopic heartbeat

What is meant by an ectopic heartbeat? I was diagnosed with this condition following a recent pre-employment medical examination. I had been with my own doctor a week before and he hadn’t found any problem with my heart when he examined me.

An ectopic heartbeat is an irregularity of the heart rate and heart rhythm involving extra or skipped heartbeats. Ectopics can be described as small variations in an otherwise normal heartbeat that cause an irregular pulse. They often occur without an obvious cause and are usually harmless. Sometimes however, they can be associated with a heart rhythm problem (an arrhythmia) or an electrolyte (chemical) problems in the blood, which requires treatment. They may also occur with ischemia, a decrease in blood supply to the heart, or in those with a condition that affects the heart muscle.

Ectopic beats may also be caused or made worse by excessive smoking, alcohol and caffeine. Certain prescribed medications and some illicit drugs can also cause them. A physical examination may reveal an occasional, irregular pulse. However, if the ectopic beats occur infrequently, they simply may not have been happening when your own doctor examined you.

I have no symptoms, so do I need to have this investigated further?

Like you, some individuals with ectopic heartbeats experience no obvious symptoms. However, others can experience palpitations, feelings of the heart skipping a beat, or the feeling of an occasional forced heartbeat. While ectopic heartbeats in adults are common, their causes should always be investigated even if it turns out no treatment is required. Further tests to confirm the diagnosis may include a continuous ambulatory cardiac monitoring (a holter monitor or patient-activated event monitor), an ECG, echo cardiogram or coronary angiography.

Can children suffer from ectopics or is it always adults?

Ectopic heartbeats are rare in children who do not have congenital heart disease. Most extra heartbeats in children are called premature atrial contractions (PACs), which are almost always benign.

Can ectopics be treated?

The majority of patients with ectopic heartbeats do not require any treatment, and lifestyle changes such as limiting caffeine, alcohol and tobacco usually help reduce the frequency and severity of such ectopics.

The condition may, however, require treatment if the symptoms are severe or if the extra beats occur very frequently. Where an underlying condition is found to be the cause of the problem, then this primary condition will be treated first.