Worried about couplet or triplets - British Heart Fou...

British Heart Foundation

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Worried about couplet or triplets


Hi, last night I took my BB and went to bed.

I was sitting in bed and beared down as I moved and had an ectopic beat (nothing unusual for me) but then about 5 seconds later I had another ectopic and then another straight after with no normal neat in between. I think I might have then had a third but cannot remember as I started panicking as it felt really awful.

My heart then started beating normally again.

I tried to settle to sleep but kept constantly waking in the night with my heart racing and sweating badly (the sweating is normal for me in the week before my period).

I then woke up with another ectopic beat.

I have looked up on the internet and it looks like I had a couplet or triplet and it has literally scared me to death because all the information on the net seems to show that couplets/ triplets are a marker for something terrible happening. Bad heart irritability that could go to VT or VF so I don't know what to think now :( 😭 . I've had thousands of holters and echoes and I have had these episodes before in the past but probably only once every couple of years so would never be caught on monitoring.

Can anyone help as I'm terrified now!

9 Replies

You should see your doctor ASAP.

Lucyburn in reply to jimmyq

Why would that be? I have had many many ecgs, holters and echoes and stress test which have all come back normal. What is it about 2 pvcs together that it so life threatening?

jimmyq in reply to Lucyburn

He might have info that will stop you worrying. Worrying does no good at all.

Lucyburn in reply to jimmyq

I just think it is a bit alarmist to suddenly go "contact your gp asap" without saying why. I appreciate that you've now explained why but it caused me a considerable amount of anxiety to read that without explanation in the first place.

jimmyq in reply to Lucyburn

OK In future when I advise people to see their GP I will say why.

Does anyone know the prognostic significance of couplets or triplets? I have had so many holters and echoes over the years, I can't imagine that they will be happy to investigate further but it is causing me a considerable degree of anxiety 😭

Hi Lucyburn. Sorry to hear about your cardiac issues. I understand being anxious after my heart attack last year every change of beat worried me. I wonder if it’s worth phoning the BHF helpline they have cardiac nurses who may talk you through the issues and may be able to answer some of your queries. If during an episode of heart irregularities you may consider phoning 111 for advice. I think as Jimmy says a discussion with your GP will be good. Book a 20 minutes slot with them so you don’t feel rushed. Make a list of questions that you want to ask. I always forget something so a list is good! . You don’t mention if you have seen a cardiologist if not discuss being referred to one. I took up yoga and I find the breathing exercises help my heart rate come down and even out especially after exercise or when I feel anxious. I hope you get something sorted soon. Do take care. I know it’s easy for me to say try not to worry I do do know how it feels but hopefully if you get some things sorted that may help. Do take care and let us know how you get on. Best wishes Zena


Ectopic beats are usually benign, even in couplets or triplets. One of the biggest ‘effects ‘is anxiety in the patient.skip down to the bit about treatment.

It’s very easy to read all the negative stuff on google. Don’t useit to try and diagnose a problem. Stick to the facts, it’s usually a lot less scary!

Emily_BHFBHF Nurse

Hi Lucyburn,

I am sorry to hear that you are going through this difficult time.

My first instinct would be to tell you to have a 24/48/72 hour holter monitor as this test can confirm whether you have an abnormal heart rhythm.

It is important to note that everybody experiences ectopics and this is not always a cause for concern. Frequent or symptomatic premature beats/ectopics may be due to anxiety, medication or excess caffeine. I would recommend discussing this with your doctor and look at other tests you may need.

When you get these episodes and you are worried, please do not hesitate to seek urgent medical attention and call 111 if you are unsure.

Take care,


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