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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 2 most common types of ectopic heartbeats are:

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

Causes

Sometimes ectopic heartbeats are seen with:

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 PACs. These are almost always harmless.

In adults, ectopic heartbeats are common. They are most often due to PACs or PVCs. Your health care provider should look into the cause when they are frequent. Most of the time no treatment is needed.

Symptoms

Symptoms include:

  • Feeling your heartbeat (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 provider may not find them during a physical exam.

Blood pressure is most often normal.

An ECG will be done. Often, no further testing is needed when your ECG is normal and the symptoms are not severe or worrisome.

If your doctor wants to know more about your heart rhythm, he or she may order:

  • A monitor that you wear that records and stores your heart rhythm for 24 to 48 hours (Holter monitor)
  • A recording device that you wear, and records your heart rhythm whenever you feel a skipped beat

An echocardiogram may be ordered if your doctor suspects problems with the size or structure of your heart are the cause.

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 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.

Alternative Names

PVB (premature ventricular beat); Premature beats; PVC (premature ventricular complex/contraction); Extrasystole; Premature supraventricular contractions; PAC; Premature atrial contraction; Abnormal heartbeat

References

Olgin JE. Approach to the patient with suspected arrhythmias. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 62.

Rubart M, Zipes D. Genesis of cardiac arrhythmias: electrophysiologic considerations. In: Bonow RO, Mann DL, Zipes DP, Libby P, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 33.

Review Date 5/5/2016

Updated by: 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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