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Ectopic heartbeat

Ectopic heartbeats are small changes in a heartbeat that is otherwise normal. These changes lead to extra or skipped heartbeats. Often there is not a clear cause for these changes. They are mostly harmless.

The two most common types of ectopic heartbeats are:

  • Premature ventricular contractions (PVC)
  • Premature atrial contractions (PAC)

Alternative Names

PVB (premature ventricular beat); Premature beats; PVC (premature ventricular complex/contraction); Extrasystole

Causes

Sometimes ectopic heartbeats are seen with:

  • Changes in the blood, such as a low potassium level (hypokalemia )
  • Decrease in blood supply to the heart
  • Heart muscle disease (cardiomyopathy )

Ectopic beats may be caused or made worse by smoking, alcohol use , caffeine , stimulant medicines, and some street drugs.

Ectopic heartbeats are rare in children without heart disease that was present at birth (congenital). Most extra heartbeats in children are premature atrial contractions (PACs). These are almost always harmless.

In adults, ectopic heartbeats are common. They are most often due to PACs or PVCs. Your doctor should look into the cause, but no treatment is needed most of the time.

Symptoms

Symptoms include:

  • Feeling your heart beat (palpitations )
  • Feeling like your heart stopped or skipped a beat
  • Feeling of occasional, forceful beats

Note: There may be no symptoms.

Exams and Tests

A physical exam may show an occasional uneven pulse. If the ectopic heartbeats do not occur very often, your doctor may not find them during a physical exam.

Blood pressure is most often normal.

The following tests may be done:

Electrocardiogram (ECG)

Treatment

The following may help reduce ectopic heartbeats for some people:

  • Limiting caffeine, alcohol, and tobacco
  • Regular exercise for people who are inactive

Most ectopic heartbeats do not need to be treated. The condition is only treated if your symptoms are severe or if the extra beats occur very often.

The cause of the heartbeats, if it can be found, may also need to be treated.

Outlook (Prognosis)

In some cases, ectopic heartbeats may mean you are at greater risk for serious abnormal heart rhythms, such as ventricular tachycardia .

When to Contact a Medical Professional

Call your health care provider if:

  • You keep feeling the sensation of your heart pounding or racing (palpitations ).
  • You have palpitations with chest pain or other symptoms.
  • You have this condition and your symptoms get worse or do not improve with treatment.

References

Olgin JE. Approach to the patient with suspected arrhythmias. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap. 62.

Rubart M, Zipes D. Genesis of cardiac arrhythmias: electrophysiologic considerations. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 35.

Updated: 5/13/2014

Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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