Atrial Fibrillation Association Tel: 1800 050 267 or (02) 61084602 Info@atrial-fi brillation-au.org www.atrialfi brillation-au.org Australia Ectopic Heart Beats What are ectopic beats? not be possible to catch them on an ECG so a portable monitor may be required. The ECG Normal heart beats come from the pacemaker demonstrates the electrical activity of the of the heart known as the sinoatrial node normal heart beat, with ectopic beats having which is situated in the top right hand chamber a different appearance or timing. In patients (the right atrium). Sometimes beats can be with frequent symptoms a 24 hour ECG will fi red from elsewhere and these are known as sometimes be undertaken to clarify the pattern “ectopic beats”. The word “ectopic” just means and frequency of the ectopic beats and their “wrong place” – for example “ectopic pregnancy” relation to symptoms. means a pregnancy outside the womb. An ectopic beat is an early (“premature”) or Although in most individuals ectopic beats are “extra” beat which can come from either one not a cause for concern, they can occasionally Ectopic Heart Beats - Patient Information of the upper chambers of the heart (the atria) indicate underlying structural heart disease or one of the lower chambers (the ventricles). and in this scenario may be of greater signifi cance. Further cardiological assessment These beats occur before the normal beat may be advised. However, it should be of the heart can form. Thus there is more emphasised that in most individuals ectopics opportunity for them to occur when the heart do not indicate any problems with the heart. is going slower, such as during the night with sleep or when relaxing. Ectopic beats are Treatment very, very common and in most people with no other heart disease they are harmless but The vast majority of people do not require they can be troublesome due to the sensation specifi c treatment for ectopics. If they do that they sometimes produce. Most people cause unpleasant symptoms there are things who have ectopics are completely unaware of that can be done to try to limit them. them – our awareness of what goes on in our bodies is extremely variable. They do not In some people, eliminating alcohol, caffeine, usually indicate any problems with the heart. stress, tiredness may help. Cold medicines, available without prescription, sometimes Any awareness of the heartbeat is known contain drugs such as decongestants that can as “palpitation”. An ectopic beat can be felt stimulate the heart and these are probably best as an “extra” beat in the rhythm of the heart avoided as they may increase your symptoms. or as a “thud” following a short pause in the rhythm of the heart. In this second case If symptoms are persistent and uncomfortable the additional beat of the heart actually has medical therapies can be tried. Generally the occurred in the pause and the following thud doctor would initially use a simple medication is the heart catching up. The heart is not at risk such as a beta-blocker (for example of “stopping”. Although such symptoms can metoprolol) or calcium channel blocker (for be unpleasant, ectopics will not cause any example verapamil). There are other treatments damage to your heart unless extremely that may be effective in reducing your frequent (e.g. every 2nd beat throughout the symptoms but in an otherwise healthy day and night). individual the risks of such treatment can outweigh the benefi ts. Diagnosis In general a health professional can make the diagnosis of an ectopic beat from the story that you give, but an electrical heart tracing Author: Dr Matthew Fay, GP is required (Electrocardiogram or “ECG”, or a Endorsed by: Mrs Jayne Mudd, Arrhythmia Nurse Specialist monitor) to confi rm this diagnosis. If you are Published October 2009 not having the ectopics all that regularly it may Reviewed by: Dr Campbell Cowan January 2010 A branch of AFA International For further information contact Atrial Fibrillation Association The Heart Rhythm Charity Medical Advisory Committee: Dr Michael Davis, Affi liated to Arrhythmia Alliance Professor Ben Freedman, Dr Gerry Kaye www.heartrhythmcharity.org.uk www.afa-international.org © 2010.