AF Association PO Box 6219 Shipston-on-Stour CV37 1NL +44 (0) 1789 867 502 ™ [email protected] AF A www.afa.org.uk www.afa.org.uk Ectopic heartbeats

This factsheet provides information for people In patients with frequent symptoms a 24 hour who experience ectopic heartbeats. It gives a ECG will sometimes be undertaken to clarify description of this condition, how to recognise the pattern and frequency of the ectopic beats it, and how it can be alleviated if problematic. and their relation to symptoms. Although ectopic beats are not a cause for concern in most Normal heartbeats come from the pacemaker of individuals, in those with structural disease the heart known as the sino-atrial node situated they may be of greater significance, and further in the heart’s top right hand chamber (the right cardiological assessment may be advised. ). Sometimes extra beats can be fired from Ectopic hea Frequent atrial ectopics together with a elsewhere, and these are known as ‘ectopic beats’. significant CHA2DS2-VASc score may be an An ectopic beat is an additional beat which can indication of underlying AF. Some schools come from either the upper chamber of the of thought consider that ectopic episodes or heart (the atrium) or the lower chamber (the lasting more than 30 seconds actually

). The beat occurs just before the normal are AF, and should be assessed for stroke risk. r heartbeat. Ectopics tend to occur when the heart tbeats - P If a person is otherwise fit and healthy, all that is rate is slower, such as when we are relaxing in the usually needed is reassurance and advice, such evening or sleeping at night. as cutting down on anything that may be acting Ectopics can either be felt as an extra beat in the as a stimulant, for example alcohol or caff eine. rhythm of the heart or as a thud following a short Stress can also trigger ectopic beats. Off the atient information pause in the rhythm of the heart. In this second shelf cold and ‘flu medicines sometimes contain example the additional beat of the heart actually decongestants and other drugs that can stimulate has occurred in the pause, and the following thud the heart, and these are probably best avoided. is the heart catching up. If symptoms are persistent and uncomfortable, Ectopic beats are common, and in most people medical therapies may be appropriate. Generally with no other known heart condition they are the doctor would initially use a simple medication harmless. They carry no increased stroke risk even such as a beta blocker (for example bisoprolol). in patients with a damaged heart, such as those In patients with asthma or bronchitis, such with or who have runs of SVT. medicines cannot be used, and an alternative such as a calcium channel blocker (for example Although the symptoms of the heart missing diltiazem) may be considered. a beat or a thumping in your chest can be unpleasant or cause , they do not indicate In an otherwise healthy individual, other drugs any problems with the heart, and the extra beats may reduce the symptoms eff ectively, but their will not normally cause any damage to your heart. risks may outweigh the benefits. Normally a clinician will diagnose an ectopic It summary, ectopic beats are nearly always beat from what you have told them. A heart harmless and do not indicate any problems with tracing (Electrocardiogram or ECG) will confirm the heart. this diagnosis. Any ectopic beats will appear as a diff erent pattern on the visual trace. If the ectopics are less frequent, it may not be possible to catch them on an ECG, so a portable monitor Acknowledgements: AF Association would like to thank all those may be more likely to capture them. who helped in the development and review of this publication. Particular thanks are given to Dr Matt Fay, GPwSI, Mrs Jayne Mudd, Specialist Nurse, and Dr Campbell Cowan.

Founder & Chief Executive: Trudie Lobban MBE Trustees: Professor A John Camm, endorsed by Professor: Richard Schilling, Mrs Jayne Mudd and Dr Matthew Fay endorsed by ® www.aa-international.org Atrial Association Registered Charity No. 1122442 Affiliate © Published October 2009, Reviewed February 2014, Planned Review Date February 2017 Please remember that this publication provides general guidelines only. Individuals should always discuss their condition with a healthcare professional. If you would like further information or would like to provide feedback please contact AF Association.