Not a week goes by that I don’t see someone in cardiology consultation for skipping, jumpy heart beats.   It is a common problem- a problem that worries many people.

Why?  It’s unnerving to feel your heart beating. 

Most people are rarely aware of their heart’s movement in their chests.  So when a person suddenly can feel their heart, thumping erratically it often sends them to the doctor.

Should you be worried?  Should you be concerned if you feel your heart missing a beat? 

By and large skipping of the heart, what is called palpitations, are rarely serious.  The vast majority of skipped heartbeats are something called premature atrial complexes or PAC’S.  These are early heartbeats that generally arise from the upper chambers (the atria) of the heart.   Skipped beats can also arise from the lower chambers. 

They can also be due to a fast heartbeat called a tachycardia.

Normally the electrical activity of the heart begins from a pacemaker cell called the sinus node located in the right atrium.  This is the heart’s spark plug.  It fires regularly to begin the cardiac cycle.

PAC’s are a premature activation of the atria from a site different from the normal spark plug.  They can occur singly, or in groups.  They are felt as the typical turning over of the heart, and are extremely common.  As I said, most people rarely feel them. 

Yet, if they are felt it can seem strange, even unnerving.  PAC’s by themselves are rarely dangerous.  Medical studies have shown that many people have skipped heartbeats.

PAC’s show up in young people as well as older people.  You can find them in people with normal hearts and in people whose hearts are abnormal. 10-70% of normal people have PAC’s. 

In some people, however, they can lead to more serious cardiac arrhythmias.  PACs can start Atrial Fibrillation.    They may also be a sign of other heart conditions. If your heart muscle is weakened or you have an abnormality of the Mitral Valve (the valve between the left atrium and left ventricle) PAC’s are very common

PAC’s are also very common in other medical illnesses.  People who suffer from lung disease frequently have skipped heartbeats. 

Interestingly, PAC’s are seen in the normal unborn fetus. They are also occur in healthy newborns.  So having PAC’s shouldn’t overly worry you.

Another type of skipped beat is a Premature Ventricular Complex or PVC.  PVCs arise from the lower chambers of the heart, the ventricles.  They may be found in normal people but are much more frequent in people with abnormalities of the heart.   

By themselves PVCs are not dangerous, but they may indicate other types of medical illness: high blood pressure, damaged heart muscle, Valvular conditions, heart failure, electrolyte abnormalities, and other conditions.