"Skipped" beats
"Skipped" beats
Hi Rick
What you MAY be experiencing are pre-mature ventricular contractions. Pretty common, and not anything to worry about if you don't string several of them together. Note I capped the word "MAY." There could be something else going on, and it's best to have your cardio run an EKG.
I've had PVC's since my surgery 3 years ago. Frequency decreases w/ exercise in my case.
Some info below scraped from heartcenteronline.com.
Hope all is well.
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PREMATURE VENTRICULAR CONTRACTIONS
( Premature Ventricular Complex, PVC, Ventricular Extrasystoles, Ventricular Ectopics, Benign Ventricular Ectopics )
Summary
Premature ventricular contractions (sometimes called PVCs or VPCs or benign ventricular ectopics) are a fairly common type of abnormal heart rhythm (arrhythmia). In the normal sequence of events, a heartbeat is initiated in the top right chamber of the heart (right atrium) and subsequently conducted to the bottom chambers of the heart (ventricles). A premature ventricular contraction occurs when the ventricles fire early (prematurely), before the atria. They may be caused by fatigue, caffeine, alcohol, nicotine or a variety of other factors. In many cases, the cause of PVCs is unknown.
Some people may feel skipped beats or galloping palpitations, and other people may not notice PVCs at all. In general, these irregular beats are harmless. However, diagnosing them and ruling out heart disease may be important. People are also urged to contact their physician if they experience chest pain or a sudden worsening of their PVCs. If necessary, treatment generally involves taking medication, such as beta blockers or antiarrhythmics.
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About premature ventricular contractions
Premature ventricular contractions (PVCs) are a fairly common type of irregular heart rhythm (arrhythmia). They occur when the lower chambers of the heart (ventricles) beat before receiving the correct electrical signal from the upper chambers of the heart (atria). Following this extra beat, a brief pause may occur as the conduction system of the heart resets itself. This is often perceived as a skipped beat.
PVCs are generally harmless. However, in patients with underlying heart disease, frequent PVCs may signify an increased risk of ventricular tachycardia (VT) ? a potentially fatal arrhythmia.
In some cases, the cause of PVCs is unknown. In other cases, they may be due to known causes such as the following:
Anxiety or stress
Fatigue
Alcohol or other substance use (e.g., caffeine or nicotine)
Electrolyte problems (e.g., from dehydration, starvation or uncontrolled diabetes)
Lack of oxygen-rich blood to the heart (cardiac ischemia)
Past damage to the heart (e.g., from a heart attack)
Congenital heart disease
Other heart-related problems
A person?s work schedule may be another type of ?stress? from which PVCs can arise. Studies have found higher rates of PVCs in night-shift workers, as compared to day-shift employees.
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Symptoms and diagnosis of PVCs
Signs and symptoms of PVCs
Individuals with PVCs may notice palpitations ? a feeling that their heart is galloping, pounding or skipping beats. These palpitations can sometimes feel like the heart is wildly out of control and they can be quite startling or frightening. In other cases, patients with PVCs may not notice any symptoms at all.
However, chest pain, fainting spells (syncope) or suddenly worsening palpitations may indicate more serious heart problems. People are therefore urged to contact their physician immediately.
Diagnosis methods for PVCs
A patient?s physician will begin by asking the patient about his or her personal and family medical history. The physician will also perform a complete physical examination. As part of this examination, the physician may notice an irregular pulse, though blood pressure tends to be normal.
Additional tests that may be ordered include the following:
Electrocardiogram (EKG). A painless recording of the heart's electrical activity. The highly sensitive electrocardiograph machine helps detect heart irregularities, disease and damage by measuring the heart's rhythms and electrical impulses. If no unusual electrical activity is detected while the patient happens to be in a medical setting, then the physician may order the patient to wear a Holter monitor to monitor the heart?s electrical activity continuously for the next 24 hours.
Echocardiogram. This painless test uses sound waves to visualize the structures and functions of the heart. A moving image of the patient?s beating heart is played on a video screen, where a physician can study the heart?s thickness, size and function. The image also shows the motion pattern and structure of the four heart valves, revealing any potential leakage (regurgitation) or narrowing (stenosis). During this test, a Doppler ultrasound may also be done to evaluate cardiac blood flow.
Exercise stress testing. Studies find PVC symptoms occurring just after (rather than during) an exercise test may increase the overall risk of potentially fatal arrhythmias. An echocardiogram (above) will be done in order to further analyze the heart?s function, with the results helping the physician consider treatments (if necessary).
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Treatment and prevention of PVCs
Treatment options for PVCs
In general, no treatment is necessary for patients who are free of heart disease and rarely bothered by symptoms of PVCs. For those who are bothered by their symptoms, the cause of the PVCs will be addressed if it can be identified. For example, patients whose PVCs are caused by excessive caffeine intake may be asked to limit or eliminate their use of caffeine.
Patients whose PVCs appear to be associated with heart disease will be treated for those heart-related problems. If the cause of the PVCs cannot be identified, then patients may be prescribed medications such as beta blockers, which block certain actions of the sympathetic nervous system (e.g., the stress response) that could lead to a rapid heartbeat. Rarely, a procedure called catheter ablation may be necessary to eliminate the abnormal cells causing the PVCs.
Prevention methods for PVCs
Patients whose PVCs were successfully treated by eliminating the cause (e.g., caffeine) from their lifestyle are strongly encouraged to avoid that cause in the future. Strategies for preventing PVCs with no known cause are unknown.
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Types and differences of PVCs
There are a number of different types of PVC, which are classified according to different standards. For example, they may be classified according to how often the PVCs alternate with normal heartbeats:
Bigeminy. The PVCs occur every other beat.
Trigeminy. The PVCs occur every third beat.
Quadrigeminy. The PVCs occur every fourth beat.
Alternatively, more than one PVC may occur in a row and be classified as follows:
Couplets: Two PVCs in a row.
Runs of ?nonsustained? V-tach (short for ventricular tachycardia): At least three PVCs in a row. In patients with weakened pumping function of the heart due to a prior heart attack, any runs of nonsustained V-tach indicate a high risk of potentially fatal arrhythmias ventricular tachycardia or ventricular fibrillation) and usually require further evaluation (cardiac catheterization and electrophysiology study).
Furthermore, PVCs may be classified according to where they arise within the heart:
Unifocal PVCs. The PVCs arise from the same source, so that they all look the same on an electrocardiogram (EKG).
Multifocal PVCs. The PVCs arise from different sources within the heart, so that they look different from each other on the EKG.
Other classifications also exist. Patients are encouraged to speak with their physician for more information.
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This information can be found by going to
www.heartcenteronline.com
.
