What Is Ectopic Heartbeat and What Causes It?

An ectopic heartbeat is a change in the rhythm of the heartbeat. Many people experience it at some time in their lives and the cause isn't always clear. It should only be of concern if it occurs frequently.
What Is Ectopic Heartbeat and What Causes It?

Written by Edith Sánchez

Last update: 07 June, 2022

Ectopic heartbeat occurs when the heart skips a beat or adds an extra beat. In principle, this is a normal situation that shouldn’t be a cause for concern. Most commonly, it occurs for unknown reasons and has no consequences.

There are two main types of ectopic heartbeat: premature atrial contraction (PAC), when the heartbeat originates in the atria, or upper chambers of the heart; and premature ventricular contraction, if it occurs in the ventricles, or lower chambers of the heart.

Ectopic heartbeat is also known as “extrasystole” or “premature heartbeat”. Most people experience it on occasions and it feels like a slight flutter. Only if it becomes frequent does it warrant a medical consultation.

Why does ectopic heartbeat occur?

A woman clutching her heart.
The cause of the ectopic heartbeat is often not determined.

Often, ectopic heartbeat occurs without a known cause. However, some elements are associated with the occurrence of this type of heartbeat. They’re the following:

In general, ectopic heartbeat occurs when there are low levels of potassium in the blood, a reduced blood supply to the heart, or an abnormal enlargement or structure of the heart.

Research suggests that extrasystoles are the most common arrhythmias. In some patients, they can appear in cases of hypoxemia or when under the effects of anesthesia.

Some people are more prone to having this type of heartbeat. Among them are those who have a family history of this condition, or who have had a heart attack or have heart disease.

Associated symptoms of ectopic heartbeat

Ectopic heartbeat often occurs without any symptoms. In fact, the person isn’t even aware that the extrasystole has occurred. In other cases, it just feels like the heart has skipped a beat.

Sometimes symptoms such as the following may occur:

  • The sensation that the heart is fluttering
  • The heartbeat feels stronger
  • There’s a jump or brief pause in the heartbeat
  • You’re more aware of how the heart is beating.
  • Occasional strong beats
  • A feeling of weakness or dizziness

It isn’t very common, but some people also have ventricular tachycardia, which is rapid, irregular heartbeat, or other arrhythmias. If the person has had heart disease, then the risk of complications or sudden death is higher.

How is it diagnosed?

An occasional ectopic heartbeat doesn’t warrant medical consultation and, in fact, is rarely recorded during a physical examination. If the extrasystoles are frequent, it’s best to discuss them with the physician.

The physician will ask about symptoms and perform a routine physical examination. If appropriate, he or she may order tests to establish the cause of the ectopic heartbeat.

The most commonly used diagnostic tests are as follows:

  • Holter monitor. This is a device that records and stores the heart’s movement for 24 to 48 hours.
  • Electrocardiogram (ECG). This measures the heart’s electrical signals and heart rhythm.
  • Echocardiogram. This allows the visualization of the structure of the heart.
  • MRI or CT scans. These allow the heart to be visualized in detail to detect any abnormalities.
  • Stress test or exercise test. Used to visualize how the heart responds to physical stress.
  • Coronary angiography. These are X-rays with a contrast medium to detect anomalies or failures.

How can it be treated?

A woman with an apple.
If the presence of the ectopic heartbeat is common, a visit to the physician is advised.

As noted above, the ectopic heartbeat itself doesn’t need treatment. It usually disappears without the need for any type of intervention. However, if this doesn’t occur, you should explore the possibility of an underlying disease.

In the latter case, treatment consists of treating the underlying disease. If no triggering pathology is found, it’s recommended that you check out any lifestyle factors that may be producing the ectopic heartbeat.

It’s common to suggest reducing or eliminating the consumption of substances that affect the heart rhythm. It’s also often recommended that you adopt an exercise routine to strengthen the heart.

Prevention and recommendations

The best way to take care of heart health is with a healthy lifestyle. This includes a healthy diet, with a predominance of foods such as fruits, vegetables, and lean proteins.

Similarly, people at risk of ectopic heartbeats should reduce alcohol and cigarette intake, as well as the use of unhealthy drugs. In addition, regular aerobic exercise for 30 minutes, 3 to 4 times a week, is ideal to keep the heart strong.

What to do when faced with an ectopic heartbeat?

In the presence of strong palpitations and the sensation of a pounding heart, it’s essential to remain calm. Most ectopic heartbeats disappear after a couple of minutes of rest. Take a seat and breathe deeply for 5 to 10 minutes.

If the ectopic heartbeat occurs frequently, or if you experience a strange sensation in your heartbeat, it’s best to tell your doctor as soon as possible. This could be a warning sign that something is wrong with your heart. It is up to the cardiologist to determine if the situation needs to be explored further.

Medical consultation is advisable

An ectopic heartbeat doesn’t usually cause complications. However, there are also a small number of cases where it can trigger episodes of tachycardia or cardiac arrhythmia. For the same reason, it’s a symptom that should not be neglected.

You need to be alert to the presence of other symptoms, such as chest pain, very strong palpitations, a sensation of tightening, or difficulty in breathing. All of them suggest the need to consult a doctor promptly.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Benito B, Josephson M. Taquicardia ventricular en la enfermedad coronaria. Revista Española de Cardiología. 2012; 65(10), 939-955.
  • Franco E. Optimización de terapia de resincronización cardiaca en un paciente con muchas extrasístoles. ¿Qué hacer? Los Casos Clínicos más docentes del año 2017 en Cardiología. 2018; 55 (2): 130-147.
  • Lozano J. Arritmias cardíacas y su tratamiento. Offarm. 2001; 20 (11): 96-105.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.