All you need to know about Ectopic beats
| WHAT ARE ECTOPIC BEATS |
| CAUSES OF ECTOPIC BEATS |
| SIGNS AND SYMPTOMS OF ECTOPIC BEATS |
| DIAGNOSTIC INVESTIGATIONS OF ECTOPIC BEATS |
| ECTOPIC BEATS TREATMENT/HOW TO STOP ECTOPIC BEATS |
Ectopic beats are also known as Ectopic Heart Rhythm or cardiac ectopy. It is produced when the heart creates a premature beat, usually followed by a brief pause.
There are specifically two types of ectopic heart beats. They are:
1. premature ventricular contraction (PVC), or ventricular ectopics (VE),
This single lead electrocardiogram (ECG) shows a single ventricular ectopic beat (6th heart beat). This is also know as premature ventricular contraction (PVC) or ventricular ectopics (VE).
2. premature atrial contraction (PAC), or supraventricular ectopy (SVE)
This single lead electrocardiogram (ECG) shows 3 beats of atrial ectopy which occur in a flurry of rapid heart beats lasting under 3 seconds, before resumption of normal heartbeat. These beats are also know as premature atrial contraction (PAC) or supraventricular ectopy (SVE), or atrial ectopic beats.
You may have come across these terms when looking at the results of a 24 Holter or electrocardiogram (ECG),or been informed that you have ectopic beats by your doctor.
Premature ventricular contraction (PVC) originates from the ventricles or the lower chambers of the heart are the main pumping chambers of your heart.
Risk factors for PVC include ageing, past history of heart attack, cardiomyopathy (heart muscle weakness), or valvular heart disease, usually due to mitral valve prolapse or a floppy mitral valve.
However, if you are fit and well without any of these risk factors, the most common cause of PVCs are PVCs that arise from the outflow tract which can be from the right (RVOT) or left (LVOT) ventricular outflow tracts.
PACs are premature heart beats originate from the heart’s upper chambers or atria. PACs are usually considered harmless, but if they occur repeatedly in a continous manner, then you may be at risk of developing atrial fibrillation (AF), which is when there is continuous irregular PACs which occur continuosly for more than 30 seconds at a time.
Occasionally, we experience an ectopic beat when we exercise, are stressed or consume stimulants such as coffee. However, if it persists, medical practitioners investigate the underlying cause of such irregular beats. This may be due to heart disease or injury or an electrolyte imbalance in the blood.
Other ectopic heartbeat causes include:
You may feel the following:
Sometimes, you may feel no symptoms at all.
Following these are performed to pinpoint the causes of irregular heart rhythms:
Read below guide line how to stop ectopic beats ?
If possible, avoiding the triggers of ectopic beats is also key in reducing its incidences as most ectopic beats need not to be treated. However, your doctor might ask you to avoid excessive alcohol and caffeine.
Your ectopic heart beats doctor might suggest regular physical activity if you are inactive. If the triggers are related to stress, self-help methods such as meditation or mindfulness or other relaxation therapies might help.
However, if ectopic heart beats persist and are bothersome, treatment is based on the underlying cause based on the tests performed.
In most cases where the cause of ectopy are minimal PVC or PAC – usually quantified as < 1% on 24h Holter monitoring, then most patients can be safely reassured. With reassurance, and breaking the cycle of panic and anxiety, which in turn releases adrenaline, triggering further ectopy, patients can experience a significant improvement in symptoms.
Your doctor may consider a trial of drugs such as:
Rarely, if the ectopy burden is significant (typically more than 10% , or 10,000 ectopic beats out of the typical 100,000 normal heart beats in a day), with significant symptoms which continue despite medication and reassurance, a catheter ablation procedure may be performed.
Other indications for ablation include:
In a catheter ablation procedure, small electrical wires are inserted through a keyhole approach in your groin, and these are advanced into your heart. You are usually awake, and given sedation and local anaethetic for this procedure.
The source of ectopic heartbeat is mapped precisely in the heart using X-ray and modern 3D mapping equipment (electroanatomical mapping), which can then be targeted using radiofrequency (burning) to cauterise the area in the heart which cause ectopy.
The procedural success rates are usually above 80% for this procedure, and complications include 3% risk of groin bruising, 1% risk of pericardial effusion (small collection of fluid around the heart), and <0.5% risk of cardiac perforation leading to emergency surgery. The risk of stroke and heart attack is < 0.5%.
Minor infrequent ectopic or skipped beats beats which do not cause any other symptoms can usually be safely ignored and treated with reassurance and avoidance of triggers.
If your catheter ablation is successful, you can usually come off all drugs and be discharged from your doctor, as this is likely to be a curative procedure, with a low risk of recurrence.
Have you ever felt significant symptoms of palpitations/skipped beats? Contact Dr. Lim, voted best cardiologist in London an expert ectopic beats palpitations consultant, for a thorough assessment, including state-of-the-art diagnostics, and comprehensive treatment plan.