Premature beat: a patient’s point of view

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Through this text, I hope to guide you and, most importantly, reassure you about palpitations linked to extrasystoles.

I must admit that I had never experienced palpitations until one particular evening while studying quietly. I was 23 years old at the time—today, I’m over 50—and I still remember exactly how it all started.

That night, I suddenly felt as if my heart was “skipping” beats.

When I focused on it, I realized it wasn’t actually skipping beats, but rather that one was occurring too early in the normal sequence. My heart was pumping before it had enough time to fully fill, making it feel as though it was beating “into emptiness.” Then, it seemed to pause before resuming its rhythm with a stronger beat.

This cycle kept repeating—sometimes every three beats, sometimes every four or five…

Disturbing, Anxiety-Inducing!

I also noticed that when I moved—whether walking or running—my heartbeat became regular again, and those sudden jolts disappeared.

Where do these sensations come from?

Let me explain why these sensations occur in this sequence.

Each heartbeat creates a pulse that can be felt when taking the pulse. This pulsation corresponds to the volume of blood ejected by the heart into the aorta before being distributed through the arteries.

Between two beats, the heart fills with blood in preparation for the next contraction. When a contraction occurs prematurely, as with an extrasystole, the heart does not have enough time to fill completely. The ejected blood volume is then lower, which can make the pulse feel weak or even imperceptible.

Usually, the beat following an extrasystole occurs with a slight delay compared to the normal rhythm, giving the impression that the heart has briefly stopped. This pause allows for a fuller filling, resulting in a stronger contraction and a more pronounced pulse.

This is exactly what is felt during an extrasystole: a sensation of a beat “into emptiness,” a pause, followed by a stronger thump. There are various variations of this sequence, just as there are countless shades in a spectrum of colors.

They Vary Over Time

Palpitations are not a constant symptom; their presence fluctuates over time. They may disappear for a certain period and then become very bothersome at other times, even varying throughout the day.

For some people, they are barely noticeable or not felt at all, while others perceive each one distinctly.

More Noticeable in Moments of Quiet

Extrasystoles are not necessarily more frequent at these times, but they are simply easier to perceive during quiet periods of the day, such as in the evening when sitting comfortably or when lying down before sleep.

They Are Not Dangerous

It is important to remember that extrasystoles are generally harmless and without consequences.

They are simply more noticeable during moments of rest and can occur at various times of the day.

How to Help the Healthcare Professional?

Providing a precise description of what you feel helps the healthcare professional better understand what is happening and make an accurate diagnosis.

A simple way to do this is by observing your pulse. You can try feeling your heartbeat by placing two fingers on your wrist or neck. Are the beats regular? Do you notice any pauses or stronger beats?  palpitations.

Easier Said Than Done…

In my case, the doctor tried to reassure me. But while words may be easy to say, the worry and anxiety of feeling my heart “slip” remained very real.

Over time, however, I came to realize that the healthcare professional’s explanations were correct.

Some verifications

Often, there is no specific cause for this overexcitement of the heart muscle. Blood tests are usually prescribed to check thyroid function, as well as to analyze certain components of the blood. In my case, everything was normal.

It is also important to examine what we consume that might act as a stimulant for the heart, such as caffeine found in certain foods and beverages.

At my request, I tried several medications. But between the side effects and the persistence of the palpitations, I eventually stopped taking them all.

Tests That May Be Ordered

A Holter monitor and a cardiac ultrasound were prescribed for me. The 24-hour recording of my heart revealed very few extrasystoles, none of which I had even noticed that day.

However, this test can be extended to 48 hours for a more detailed analysis of heart rhythm.

Fortunately, I wear a smartwatch, which allowed me to print out my heart’s electrical recordings.

Thanks to this, my doctor was able to quickly make a diagnosis and explain exactly what was happening. As for the ultrasound, it confirmed that my heart was in perfect condition.

Today

The extrasystoles are still present, with variations in frequency depending on the seasons and times of the day. However, they have no impact on my lifestyle, and I am not subject to any particular restrictions.

A Word for You

I hope I have helped you better understand your symptoms and, most importantly, reassured you… at least a little!