How do I know if I have ventricular ectopics ? Are they dangerous?
How can ventricular ectopics be treated? Can mobile ECG technology be used to detect palpitations from ventricular ectopics (VE)?
Ventricular ectopics (VE) are one of the most common causes of palpitations and lead to
One of the largest cohorts of patients referred to a heart rhythm (arrhythmia) cardiology clinic are patients with palpitations, and of these, patients presenting with isolated ventricular ectopics (VE) are very common.
What are ventricular ectopic beats?
Ventricular ectopics can present as isolated extra or skipped beats, often with pauses followed by stronger contractions, which lead patients to feel a “forceful” heartbeat as if the heart is jumping out or lurching from the chest. This is because, during the ectopic beats, the heart can contract unusually strongly, causing an increased movement or rotation within the chest that can physically impact the inside of the rib cage, leading to the physical sensation of a jarring disconcerting movement. This sensation is usually nothing to be concerned about – it’s due to the feeling of that isolated strong heart contraction that follows a pause.
How do you treat ventricular ectopic (VE) beats?
Usually, your cardiologists would like confirmation of the diagnosis of ventricular ectopic beats. This is usually done by recording a 12 lead ECG – but frankly, this test carries a very low diagnostic yield as you have to be having these ectopics occurring in the 1 minute or so you have the ECG recording. What is much more common is that the ectopic beats are sporadic and it is difficult to “capture” these live on the ECG.
Mobile technology devices such as the AliveCor Kardia Mobile or the Apple Watch (Series 4 and above) may be used effectively to capture such ectopic beats, as shown in the video below.
Where patients are unable to capture these on handheld devices or the Apple Watch, a prolonged ECG monitor (Holter) may be used to continuously record ECGs over a 24, 48, 72h period, or sometimes even a 14 day period. These devices are easy to fit, and can usually be posted to the patient’s home address, and be mailed back for analyses prior to review. What we are looking for are traces that correlated to patients’ symptoms, so be sure to actively make entries of times and symptoms in a diary that you can return with the monitoring devices. Your doctor will be able to then analyse these particular times for arrhythmia and explain what causes your palpitations.
Dr Lim will be able to send monitors to your home, and analyse and explain these data to you, and suggest an appropriate management plan to help treat these palpitations, or if he can, to fully reassure you about these with a clear explanation.