Ectopic beats

An ectopic beat is an 'extra' heartbeat that is followed by a normal heartbeat. They are very common and most of us have them. Ectopic beats can come from the atriums or the ventricles and are usually harmless. The impulse that causes the extra beat is generated somewhere in the heart outside the sinoatrial node (the natural pacemaker part of the heart). Beats that come from the atriums are referred to as ‘supraventricular’ and beats from the ventricles are referred to as ‘ventricular'.

Ectopic beats are usually harmless. They occur more in young people and can be caused by alcohol, caffeine and nicotine.

Ectopic beats from the ventricles are less common than those from the atriums and usually occur in the elderly. They can occur in healthy people, where they are harmless. They can also occur after a heart attack or heart surgery. In this case the ectopic beats can lead to more dangerous heart rhythms that may need electrical treatment.

The main symptom of ectopic beats is being aware of an abnormal heart rhythm. It may feel like a thud in the chest, an irregular heart rhythm, or a missed heartbeat. If you have ectopic beats and you are elderly, the ectopic beats are frequent, or you have other symptoms such as breathlessness or chest pain, you should get medical advice. Sometimes ectopic beats have no symptoms at all and you may not notice them, or you may feel them as a 'missed beat' rather than an extra beat.

An ECG, which traces the electrical activity of the heart rate and rhythm, is usually carried out to find out what type of altered heart rhythm (if any) is present. You may need to be attached to a monitor for 24 hours, as ectopic beats can come and go at any time of the day or night.

The doctor may want to do other tests to find out the underlying cause of the ectopic beats (for example, coronary artery disease).

The occasional extra beat may not need any treatment. However, if the ectopic beat comes from the ventricles, you may need to take medication to treat the ectopic beats. The medications that can be taken are:

• Amiodarone; and
• Betablockers.