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Missed beats

HP2503 profile image
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Hi. Has anyone had any arrhythmias which feel like missed heart beats??

Sometimes I am aware of them and sometimes not . My heart can beat 2 or 3 times and miss a beat. This can happen in sequence or can beat 10 or 20 times and miss one. Then it can be normal for hours without me feeling it or being aware if it missing beats or not. My blood pressure is fine and I’m not breathless. My heart rate has sometimes been 42 with so many missed beats. I’m 56 so am aware of how reducing female hormones can affect the body but did start HRT last November and arrhythmias stopped for a time . I have quite a sedentary job but walk daily with my dog. I also have an exercise bike. Anyone else had this at all please- male or female?

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HP2503
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I’m not medically qualified and you should speak to a doctor about your symptoms, particularly as your heart rate is ending up a bit on the low side, but the sensation of missed or skipped beats is commonly attributable to ectopics. These aren’t missed beats at all, but actually premature beats: they come early, meaning the gap between that beat and the next one is longer. They are extremely common, and although there are some exceptions, generally not cause for concern in the vast majority of cases, it’s just some people are aware of them where others aren’t. Some people might only have a dozen ectopics a day but feel every one, someone else might have thousands (literally) and not feel many if any of them. There’s also evidence that the body becomes attuned to noticing them, so if you become aware of having them, you’re likely to start noticing even more, although there may be periods lasting weeks or months where you don’t notice any at all. You can have ectopics that originate from the atria, called premature atrial contractions (PACs), and ones that originate from the ventricles, called premature ventricular contractions (PVCs), or a mixture of both. I have a mixture of both that I only became aware of in my early 20s due to developing an arrhythmia triggered by ectopics, and although I have a lot less than I used to as a result of medication and lifestyle changes - a dozen or so instead of several hundred - I still feel several most days, particularly when relaxed or settling to sleep. Although some people are more prone to them when stressed or anxious (triggered by the sympathetic nervous system), they can often also be more noticeable when we’re relaxed because the heart rate is lower (triggered by the parasympathetic nervous system), and there is believed to be a hormonal link in women, as well as lifestyle factors that can contribute for some people. Some people can also have ectopics triggered by position: I often get them if I lie on my left side, and have had them bending forwards unpacking the shopping before.

In any event, I would recommend speaking to your GP: a 24 hour monitor will help to determine what’s going on, including picking up ectopics if you’re having them, and a GP can request this. If it does turn out to be ectopics and there are no other concerns, there are some really good videos on YouTube by a well known U.K. cardiologist by the name of Sanjay Gupta.

HP2503 profile image
HP2503 in reply to

Thank you so much for replying . I’m seeing a cardiologist on Friday. The info you gave was really helpful thank you

Mart25 profile image
Mart25

Good morning. I have exactly what you describe. Episodes of 2 or 3 beats and then an apparent "missed beat". Sometimes the "missed beat" is followed by an apparent bigger beat. I think I've probably had it for years and years (I'm now 67) but I only became really aware of it properly about 8 years ago. I went to the GP then who did an ECG and found nothing wrong. His conclusion was much as described by Charlie_G : these are ectopic beats and very common and of no concern. With the benefit of hindsight, I think my GP should have referred me to a cardiologist for a 24 hour monitor just to be sure, but he didn't. Since then I've been aware of short episodes of missed beats and (similar to Charlie_G) I usually get them when relaxed watching the TV or as I go to sleep at night. I'm now so used to them that I'm sure they happen frequently but I'm just not aware of them. Much more recently I've had a heart bypass operation (for reasons not-connected with the missed beats) and I still get the same "2 - 3 beats and a miss" thing but now I'm taking a low dose of bisoprolol which I think reduces the frequency of missed beats episodes. Your cardiologist may put you on a 24 hour ECG monitor just to check things out but I suspect you have nothing to worry about.

HP2503 profile image
HP2503 in reply to Mart25

Thank you very much for replying. I’m hoping it’s nothing serious. I’ve never smoked, rarely drink and eat healthily most of the time. Probably should do... and would like to do... more exercise but that’s down to time. Fingers crossed. Thank you again

NathanBlau profile image
NathanBlau in reply to Mart25

Your “missed” beats sound like the problem I had - took a long time to diagnose as PVC as the ECG tat does not detect it.

As I understand it the Premature ventricular contractions are not picked up by ECG as that is measuring the electrical impulse and not the physical beat. With this condition only the ventricle contracts and does not eject blood fully. A subsequent compensating “bigger” beat is like the one you describe.

I had a couple of investigations but it was only discovered by an ambulance man who watched a prolonged ECG and felt my pulse at the same time - it was his observations that eventually led to a correct diagnosis. I owe him a massive thank you!

HP2503 profile image
HP2503 in reply to NathanBlau

Wow, thank you for replying. I’ve just had a read about that and does sound similar. I had an ECG today at my GP practice and nothing abnormal detected. But I will definitely ask the cardiologist about this on Friday and if it’s a possibility. What was the advice you were given for this please? And are you taking any medication. I’m hoping to not need any medication.

NathanBlau profile image
NathanBlau in reply to HP2503

My problems started in December 2019 and I took Bisoprolol for a few months and whilst it did mask the issue it caused me a lot of problems with a very low heart rate and resultant inability to remain as active as I would like. I took this for the first 6 months but this was eventually reassessed.

I was initially getting the PVC beats around every 3-5 beats and found it really very wearing as it had a similar effect that you would get when you are surprised or afraid - a real adrenaline rush. So I would sometimes have several hours of it, and be worn out and irritable by the time it settled down.

Oddly, if I cycled slowly at first my heart would eventually (not always) go into a normal rhythm. It was almost as if I had given it some real work to do so it quit “messing around” :)

I had an ablation in June 2020 and (touch wood) have not had a recurrence of PVC since. I think a more usual progression is to try a cardioversion first but for reasons unknown I was steered towards the ablation.

Sincerely hope you find a successful route through this.

Btw ..... Consultant stopped the Bisoprolol about a week or maybe two after the procedure when it was clear I was in a persistent regular rhythm.

Brindlebob profile image
Brindlebob

Sounds similar to my experience. I’m male 50, had a heart attack two weeks ago, and had 3 stents fitted and generally felt well since. I was sat last night and was aware of fluttering and skipping beats for most of the evening. It was stressing me out under the circs. However I have been aware of this especially while sat doing nothing a few years ago. I do get dizzy if I’ve bent down to pick something up. After a look on nhs direct it sounds like Arrhythmia. I’m at the Drs tomorrow so will bring it up then.Regards

EMBoy profile image
EMBoy

There is a series of arrhythmias known as heart block where the more severe stages do cause missed beats as well as light-headedness, syncope (fainting) and the possibilities of cardiac arrest or sudden death. I have a stage 3 block that was treated with a pacemaker after I fainted, and I'd just like to say that you should get it looked at as soon as possible. An ECG is needed to make the diagnosis. You may not have heart block, but it is better to be safe than sorry.P.S. I also get ectopics that feel like a missed beat, but I know that my pacemaker will pick up any true missed beats.

All the best.

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