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Frequently Asked Questions
About Ectopic Heartbeats
(Premature Ventricular Contractions)

These are questions and answers about ectopic heartbeats in general, about the different types of ectopic beat, the symptoms and causes of ectopic heartbeat and things that can be done to help get rid of ectopic heartbeats.

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What are other names for ectopic heartbeats?
Premature ventricular contractions
Irregular heartbeat
Missed beats
Extra beats

What are Ectopic Heartbeats?
Commonly known as PVC’s, ectopic heartbeats are beats that have their origins in the ventricles of the heart rather than from the sinoatrial (SA) node. PVCs are termed premature because they are triggered before the normal heartbeat occurs.

How is the heart supposed to work?
The heart is built like the old stereotypical English house – two up, two down. The two upstairs chambers are called the Atria (plural of atrium). The two downstairs chambers are called the ventricles.

The two upper atria receive blood from the veins and lungs and deliver it to the lower ventricles. The ventricles accept blood from the atria and deliver it to the lungs and to the rest of the body. The low-oxygen venous (from the veins) blood arrives in the right atrium and is then passed to the right ventricle. From there it is pumped to the lungs for enrichment with oxygen. From the lungs, the blood enters the left atrium and is passed to the left ventricle where it is pumped back to the body through the arteries.

The timing for the heartbeat comes from an area in the right atrium called the sinoatrial (SA) node. This initiates an electrical impulse that causes the heart to beat. It first activates the atria to beat then crosses to the ventricles over a bridge called the atrio-ventricular (AV) node and then causes the ventricles to beat.

What happens during an ectopic heartbeat?
An electrical impulse originates in the ventricle causing the ventricle to contract before the impulse from the SA node arrives. All of the heart muscle is inherently rhythmic, which means that any part of it can produce electrical signals. Under normal circumstances, the only signal comes from the SA node.

The ventricle starts to beat before the signal from the atrium crosses the AV node bridge, but is only a portion of the way through the beat as the second signal arrives, causing an incomplete and inefficient beat to occur. People with this condition report a feeling that the heart stops briefly before resuming with a “bang”. This condition is sometimes known as extra beats because two (incomplete) beats occur.

After the incomplete beat, the heart resets itself and the resuming beat is usually stronger than usual, causing the feeling of a “bang”.

The course of events is:
Normal beat – incomplete beats – pause to reset – stronger beat – normal beat

What are the symptoms of ectopic heartbeat?
Depending upon the severity of symptoms, these can vary from none at all, in which case the problem is only usually picked up during testing for other complaints, to distressing palpitations in chest and sometimes in the neck. The palpitation feeling is due to the more forceful heartbeat following an ectopic beat

How common are ectopic heartbeats?
They are quite common. There are many people who have ectopic heartbeats and suffer no symptoms.

Ectopic heartbeats are more common as we get older, in people with hypertension (high blood pressure) and in people with various heart diseases. Ectopic beats can also occur in young, fit & healthy individuals who don’t suffer from heart diseases or high blood pressure.

What are some of the causes of Ectopic heartbeats?
In the course of emailing many people who buy this course, I have found that stress in one form or another is the single highest common factor in otherwise healthy people who suffer from ectopics.

According to western medicine, other contributing factors are thought to be hypertension (high blood pressure), being overweight, overindulgence in alcoholic or caffeine containing drinks, drug use – especially cocaine and low blood levels of potassium and magnesium.

There are a number of heart disease related causes but as they are outside the scope of the Breathe Easy Program, we will just acknowledge that these exist.

Can I get more than one ectopic beat at a time?
Yes, there are instances where ectopic beats occur every second beat (bigeminy, pronounced bi-gem-i-ny), two consecutive ectopic beats (Couplets), or three consecutive ectopic beats (triplets).

When frequent ectopic beats occur, they can on some occasions cause dizziness. This is due to the reduced ability of the heart to pump blood around the body.

People who experience more than three consecutive ectopic beats in a row have what is known as ventricular tachycardia. When prolonged, ventricular tachycardia can result in low blood flow, low blood pressure, and fainting. In some instances, ventricular tachycardia can also develop into ventricular fibrillation, which is a fatal heart rhythm (see below). This occurs mainly in people who suffer from heart disease.

Are there any health risks associated with ectopic heartbeats?
Ectopic heartbeats in healthy individuals without high blood pressure or heart diseases do not pose any health risks. This is why your doctor or cardiologist will tell you to just live with it.

Ectopic beats in people who also suffer from some heart disease run the risk of developing ventricular tachycardia, this is why it is important to get a diagnosis from a cardiologist. Ventricular tachycardia can develop into ventricular fibrillation, which if untreated, can be fatal. The Breathe Easy Program is not recommended for people who suffer from underlying heart disease.

What medications are used for ectopic heartbeats?
If you do not suffer from underlying heart disease, most doctors will not prescribe medications for your ectopic heartbeat.

If heart disease is present, medications will be given to treat the disease itself and to prevent ventricular tachycardia. Some medications are described below:

Anti-arrhythmia medications
These medications are given to help stabilize and reduce ectopic heartbeats. The aim is to prevent ventricular tachycardias and subsequent ventricular fibrillations. Beta-blockers are one such medication.

There is little evidence that controlling ectopic heartbeatss with such medications prevent ventricular tachycardias and ventricular fibrillations. Some anti-arrhythmia medications can actually be the cause of abnormal heart rhythms in some people. Please discuss this with your doctor.

Beta blockers
Again, we include Beta blockers but of a different type. There are a number of types of beta blocker on the pharmacy shelf. The types given for heart attack reduce the action of adrenaline and relieve muscular stresses on the heart. They also slow down the heart rate and they decrease the force of heart contractions, giving the heart a rest. Through this, they limit the damage to the heart during a heart attack.

Beta blockers also come with a number of potential side effects. These are listed as abnormally slow heart rate, increased wheezing in asthmatics and they can bring on heart failure in people with significant heart muscle damage.

What is Cardiac Ablation and can it help me?
When the heart's electrical system goes awry as explained above, one course of action is to destroy the bit of heart tissue that is causing the problem.

Ablation is a relatively non-invasive surgical technique that involves feeding a catheter into a blood vessel and guiding it to the heart. In the heart, electrodes at the end of the catheter take electrical measurements to find the exact location of the problem. Once found, the tissue causing the stray signals can be destroyed by exciting the tip of the catheter with an electrical current.

This technique is used to control a number of serious problems as well as ectopic heartbeats in people who don't want to take drugs because of potential side effects or where the drugs are ineffective.

This sounds like a wonderful way of overcoming ectopic heartbeats but you should remember that to effect this, a part of the heart tissue needs to be destroyed. For people with life threatening issues, this is not of much concern but for otherwise healthy people, this should be given a lot of thought.

Also, a number of people who buy the Breathe Easy Program have already tried ablation but have found that whilst the ablation was initially successful, another part of the heart starts playing up and the ectopic beats start again. This process is not 100% effective and you should discuss this with your doctor.

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