What is an ectopic heartbeat?
An ectopic heartbeat is a type of arrhythmia (irregular heartbeat). It happens when your heart contracts (beats) too soon. Your heart can also skip a beat or feel like it’s racing or fluttering.
Most of the time, an ectopic heartbeat is harmless and doesn’t result from an underlying heart problem or health condition. Your heart usually works properly even though it beats out of rhythm. Many people don’t need treatment for an ectopic heartbeat.
These irregular beats can result from too much caffeine, alcohol or stress. See your healthcare provider if you have concerns about your heartbeat, especially if you have a heart condition or your heart beats out of rhythm often.
What are the types of ectopic heartbeats?
There are two main types of ectopic heartbeats:
- Premature atrial contraction (PAC), which results from abnormal electrical signals in the top two chambers of your heart (the atria). Healthcare providers also call PACs atrial premature beats.
- Premature ventricular contraction (PVC), which results from abnormal signals coming from the bottom two chambers of your heart (the ventricles). Healthcare providers also call PVCs ventricular premature beats.
Who might get an ectopic heartbeat?
Ectopic heartbeats are more common in older people, but they can happen to people of all ages. Children who have an ectopic heartbeat usually have a PAC. You’re more likely to have an ectopic heartbeat if you have:
- A family history of ectopic heartbeat.
- A heart condition (such as heart disease) or a structural problem, including valve disease.
- Had a heart attack in the past.
How common are ectopic heartbeats?
Ectopic heartbeats and heart palpitations are very common. Nearly everyone has a PVC or PAC occasionally, but not everyone feels them.
Symptoms and Causes
What causes an ectopic heartbeat?
Ectopic heartbeats can result from:
- Alcohol and drinks that contain caffeine. Foods that are high in fat, sugar or carbohydrates can also cause an irregular heartbeat occasionally. Many people experience heart palpitations after eating.
- Anxiety and stress.
- Drug use, including nasal decongestants that contain pseudoephedrine.
- Extra weight and obesity. People who carry extra weight have a higher risk of abnormal heart rhythms and heart disease.
- Hormonal changes during menopause and changes that happen to your body during pregnancy. Heart palpitations during pregnancy are very common and usually harmless.
Less often, an ectopic heartbeat is the result of a heart problem or health condition, such as:
- Arrhythmias, including atrial fibrillation (Afib) and tachycardia (fast heart rate).
- Heart disease, coronary artery disease (CAD) and heart failure.
- Lung conditions such as chronic obstructive pulmonary disease (COPD).
- Structural heart problems.
What are the symptoms of an ectopic heartbeat?
Some people don’t experience any symptoms of ectopic heartbeat. Other people feel symptoms when they lie down or try to go to sleep (heart palpitations at night). You may feel:
- An extra heartbeat, or as if your heart skipped a beat or stopped for a moment.
- Irregular heart rate, as if your heart is speeding up and slowing down.
- Pounding or fluttering in your chest.
- Racing (fast heartbeat).
Diagnosis and Tests
How is ectopic heartbeat diagnosed?
Your healthcare provider will ask about your symptoms and listen to your heart. They’ll do a test called an electrocardiogram (EKG or ECG). This 15-minute test monitors your heart rate using sensors that attach to your skin. You get this test in your healthcare provider’s office.
If the EKG doesn’t detect an irregular heartbeat, your healthcare provider may recommend a Holter monitor, which is a type of ambulatory monitor. This portable device records your heart rate along with any irregular heartbeats. How long you wear a Holter depends on how frequently these irregular beats occur. These can be worn for two days or up to two weeks.
Management and Treatment
How do providers treat an ectopic heartbeat?
You may not need treatment for ectopic heartbeat. Most PVCs and PACs are harmless. Your healthcare provider will recommend lifestyle changes, such as avoiding caffeine and alcohol. You can also try meditation, yoga and other relaxation techniques to lower your stress level.
If an ectopic heartbeat happens often and it’s impacting your daily life, your healthcare provider may recommend a beta-blocker. These medications slow your heart rate and make it more regular.
If a health condition or other health problem is causing an ectopic heartbeat, your healthcare provider will treat the condition. Treatments vary depending on the cause. They may include arrhythmia medications.
How can I reduce my risk of ectopic heartbeat?
You may not be able to prevent ectopic heartbeat or other types of arrhythmias. But you can lower your risk by:
- Avoiding caffeine, alcohol and cold medications that can make your heart race.
- Maintaining a healthy weight if you carry extra weight.
- Managing anxiety and stress levels.
- Staying hydrated by drinking plenty of water.
- Talking to your healthcare provider about a plan to quit smoking if you smoke.
Are there other conditions that put me at higher risk of ectopic heartbeat?
If you have COPD, heart disease, structural heart problems or other arrhythmias, you have a higher risk of ectopic heartbeat. See your healthcare provider for regular checkups so they can monitor your health.
Outlook / Prognosis
What is the outlook for people with ectopic heartbeat?
Most people don’t require treatment for ectopic heartbeat, especially if the irregular beats happen infrequently or very transiently. Many people find relief from these irregular heartbeats when they make changes to their diet or lifestyle. If PACs or PVCs are getting in the way of your daily life, talk to your healthcare provider.
If you have a heart problem or other health condition, talk to your healthcare provider about your prognosis to evaluate if the abnormal rhythm is related. The outlook varies depending on the condition. People who have structural heart problems are at risk of life-threatening heart conditions, such as ventricular tachycardia.
When should I see my healthcare provider about ectopic heartbeat?
Talk to your healthcare provider if you have concerns about your heartbeat. It’s important to schedule a visit to rule out heart problems or other health conditions that could be causing your symptoms.
Get immediate medical help if you have:
- Difficulty breathing or shortness of breath.
- Persistent palpitations.
- Discomfort, tightness in your chest, or chest pain.
- Dizziness or confusion.
- Fainting (syncope) or loss of consciousness.
- Sudden fatigue.
- Swelling (edema) in your limbs, especially your legs, ankles and feet.
A note from Cleveland Clinic
An ectopic heartbeat usually isn’t dangerous. Most people find relief from these irregular heartbeats when they avoid caffeine, certain medications and alcohol. You can also reduce your risk of ectopic heartbeat by managing stress levels and getting help for anxiety. If you have concerns about your heartbeat, see your healthcare provider. It’s always a good idea to schedule an evaluation to rule out serious problems. See your healthcare provider right away if you have a heart condition, if you’ve had a heart attack or if you have structural heart problems.
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