Premature Beats – The Medical Point of View

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The heart has its own unique electrical system. Its function is to synchronise the contractions effectively.

An electrical system managed by a conductor

The leader of the electrical heart system is situated at the top of the heart, in the right atrium.

A cluster of cells called sino-atrial node is in fact the natural pacemaker for the heart. This node is responsible for all heartbeats as well as the frequency, or rate.

An organised electrical transmission

The electricity generated is transmitted to the atria following different steps of the electrical system; the electrical customs and the rapid conduction network in the ventricles.

 

The heart is not always as regular as clockwork.

The extrasystoles

As the prefix “extra” in their name indicates, extrasystoles are additional heartbeats that occur prematurely, meaning before the normal heartbeat.

The electrical system can be overexcited. The extrasystoles are supplementary heartbeats, either extras or premature, or before their time, pulses.

The extrasystoles may be a consequence of an overexcited system at the atrium and/or ventricle levels.

Almost everybody has them

The heart can skip a beat or pump once too many hence the word “extrasystole”. This is normal.

In fact, it occurs in practically everybody, every day, without any appearance of symptoms.

 

Diverses descriptions de ces palpitations ont été émises

The palpitations may vary from one person to the other… Here are examples of the sensations that can be felt:

  • The heart stops and restarts
  • The heart sighs
  • The heart pumps for nothing
  • The heart goes on a roll
  • The heart skips some beats

 

The electrocardiogram shows this:

Other possible symptoms

A short thoracic pain or streak of lightning may be perceived.

Most often, these symptoms are benign and will disappear, or at the very least, tolerated.

Certain stimulants increase the extrasystoles

The heart irregularities may be amplified by certain stimulants like coffee, some types of medication or illegal drugs, or simply stress and fatigue.

Palpitations felt at different moments of the day

Often, there are few associated symptoms.

Certain individuals are more sensitive to the heart rhythm irregularities. They can suffer from annoying symptoms they often describe as palpitations. These symptoms can vary during the day. They are often felt after eating or at bedtime.

Better noticeable in calm moments

Extrasystoles happen at any different moments throughout the day. They are simply better noticeable in calmer periods of the day.

A certain variation

Extrasystole palpitations vary throughout the day, but may also vary over the course of a year. Some people show more symptoms in a given season and less in another.

Taking the pulse is important for the doctor.

Extrasystoles can be perceived when taking the pulse. Also known as pulsation, it can be measured at the wrist or at the neck.

The description of the pulse during these episodes of palpitations is of great help to the healthcare professional.

Usually, the pulse is well-paced. An early pulse, of lower intensity and followed by a long delay before the next one, is a classic.

Another common example consists of 2 to 3 pulses closer together with a return to a regular pulse.

Finally, taking the pulse can clarify if the heart is indeed the cause of the palpitations. In the event that the pulse is regular during the moments of palpitations, the possibility that the heart is the cause is ruled out.

Possible tests

The health professional can verify the frequency and the location of the extrasystoles in the atriums and/or in the ventricles using a holter.

He can also demand an echocardiogram to take a look at the heart’s structure.

A disappointing therapy

A therapy to eliminate extrasystoles is rarely prescribed. It has secondary effects and do not solve all the palpitations.

They are annoying, but they don’t kill us…