Ectopic heartbeats are small changes in an otherwise normal heartbeat that lead to extra or skipped heartbeats. They often occur without a clear cause and are most often harmless.
The two most common types of ectopic heartbeats are:
Sometimes ectopic heartbeats are seen with:
Ectopic beats may be caused or made worse by smoking, alcohol use, caffeine, medications such as stimulants, and some illicit 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), which are almost always harmless.
In adults, ectopic heartbeats are common. They are most often due to PACs or PVCs. Their causes should be investigated, although usually no treatment is needed.
Symptoms include:
Note: There may be no symptoms.
A physical examination 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 usually normal.
The following tests may be done:
Limiting caffeine, alcohol, and tobacco may reduce the risk and frequency of ectopic heartbeats in certain people. Exercise often helps 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 discovered, may also need to be treated.
Sometimes, ectopic heartbeats may mean you are at increased risk for other serious abnormal heart rhythms, such as ventricular tachycardia.
Call your health care provider if:
PVB (premature ventricular beat); Premature beats; PVC (premature ventricular complex/contraction); Extrasystole
Olgin JE. Approach to the patient with suspected arrhythmias. In: Goldman L, Schafer AI, eds. 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 by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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