Are ectopic heart beats dangerous?

hi my name is Sanjay Gupta I'm a consultant cardiologist in York and today I wanted to do a little video on the subject of ectopic heartbeats um and um uh the question predominantly is are ectopic heartbeats dangerous so I've done a few videos now on palpitations and ectopic beats and by Far and Away the commonest question I get is are these dangerous so this video is for those people who get intermittent skipping or fluttering of the hot where it almost feels like a big misbeat followed by a thud so in essence I'll tap it out this is what the heartbeat feels like normal normal normal normal normal and then misbeat and then cut normal normal normal foreign this is incredibly common these days we get a lot of patients who come in complaining of ectopic Heartbeats And there's lots of reasons why people are getting ectopic heartbeats and I've done a series of videos on sort of lifestyle and changes in lifestyle that can be made to overcome it topic heartbeats um a lot of people then go and have an ECG and a 24-hour ECG and they're told look these you've got ectopic heartbeats they're not dangerous but a lot of people don't feel reassured by that and so today I thought I would try and Tackle this issue are they dangerous and the answer is yes they can be dangerous okay um but only in a minority of patients and the majority of times they're not dangerous who are um so there's two things okay the first thing is do you have a structurally normal heart is your heart otherwise a strong heart or a weak heart now why is that important because when you get an ectopic Beat It means that your heart is being activated from somewhere other than where it's meant to be activated that's not a terrible thing but it does mean that the heart is not going to for that one beat the heart is not going to beat us strongly as it would now imagine if you have a series of ectopic beads um so if you have 20 ectopic beats during those 20 ectopic beats the heart is beating much weaker than it would therefore less blood is going around the body and the body will suffer symptoms in keeping with less blood flow so you will feel tired may feel breathless you may feel dizzy and also the heart May lack blood itself because the heart although it's a pump it also needs blood to supply itself the muscle so if you've got less blood going around the heart is going to get less blood however if you have a strong heart if you have a normally strong heart then the heart will cope with that okay but if you have a weak heart or if you have an abnormal heart from childbirth then the heart may not be able to cope with a lot of ectopic beats in a row so if you get you know let's say 100 ectopic beats in a row the heart may not cope with that if it is already weakened and therefore the first way to try and define whether your ectopic beats could be dangerous or not is to try and know whether you have inherently a strong or a weak heart and the way to do that is to have an echocardiogram so you go to your GP or your cardiologist they scan your heart with an ultrasound and they see whether every contractions every heartbeat results in a meaningful strong contraction and they will give you something called an ejection fraction which tells you how much heart you know how effective the heart is and um we usually use an ejection fraction of 60 so if you have an injection fraction of 60 percent then by uh very definition that tells you that you have a strong heart in addition it's important to know that the valves are okay there is no scarring of the heart and an echocardiogram will tell you all that if you have a strong heart then in general your palpitations are or your ectopics are not going to be dangerous okay um on the other hand if you have a weak heart then they could be dangerous the second thing to say is that it is useful to know if the ectopics get worse when the heart is stressed or get better when the heart is stressed so sometimes like topics can be a sign of irritability of the heart and sometimes it can mean that this irritability is being caused because the heart is lacking blood for whatever reason so if you have heart artery narrowings that can cause the heart to lack blood and that irritability can be manifested as ectopic Beats but usually if that is the case then you find that there is an increased preponderance of ectopics or palpitations on exercise which get better with rest it is a very reassuring sign if the ectopics get less on exercise and therefore I often ask patients when they come to me and say oh I'm getting a job because I said you get them at rest or do you get them more on exercise and the majority of people will say I get them more addressed when I'm thinking or stressed and I get less when I'm exercising and I tell them that that's a good sign and it is a good sign but if you are finding that your ectopics are getting worse on exercise then I think that could possibly signify a bit of danger and it's worth getting that checked out now the third question is can having lots of ectopics cause your heart to weaken in some way and you're right because the ectopics are coming from somewhere else uh their the heart is not being activated in the way it's meant to be activated and so if you are getting say 25 000 ectopics a day you know if 25 of all your heartbeats are ectopic beats then it is quite likely that as time progresses over a number of your of your years your heart could weaken and if that happens then you can develop something called heart failure where the heart is becomes weak and is not able to fulfill the body's requirements and so it is quite nice to get the um the number of ectopics you're suffering from Quantified by means of a 24-hour ECG if you're getting you know uh a thousand dick topics a day that's by no means dangerous I wouldn't recommend that you do anything about them if you're getting 25 000 ectopics a day then yes I think it is worth trying to work out why you're getting so many egg topics a day you should definitely have an echocardiogram you should definitely have an exercise test and it is definitely worth suppressing them and the way you can suppress them is firstly try and identify things in your lifestyle that could be contributing to them but also using things like beta blockers to suppress them it doesn't mean that you have to have beta blockers for life sometimes you can suppress them and then after a few months you can come off the beta blockers that they don't require it's quite intangible sometimes to try and work out why topics come on and why they really become very frequent from time to time but I agree that if you are getting a lot and a lot of big topics then it is worth suppressing them finally if you're getting a lot of ectopics and they can't they can't be suppressed by beta blockers then another option is to go and see an electrophysiologist who can ablate them for you and I do recommend ablation in people who are getting extreme numbers effect topics for the simple reason that I worry that even though they may have a strong heart now if they continue to have that number of ectopics over a period of time they could develop a cardiomyopathy or a weak heart and that's what I do but if you don't have any of those things then on the whole urac topics are um not serious and they will just go away with time so I hope this has been useful um you know um um I'm always happy to chat to people about direct topics and if you want to get in touch with me you can do so um I work at York I have a website and you can send me messages using my website and I do try and respond whenever I can I have a secretary um and she's on this number her name is Jeanette so you can get in touch with her if you want to speak to me um but I would prefer if you get in touch with me through the website because then the message comes directly to me um I'm also on Twitter and I'm also on Facebook so um I wish you well uh thank you for listening and all the best

Channel: York Cardiology

Views: 130,041

Keywords: Heart (Anatomical Structure), ectopics, pvcs, pacs, skipping, fluttering, heart failure, echo, york, Heart palpitations anxiety, Heart palpitations after eating, Heart palpitations causes, Heart palpitations symptoms, Heart palpitations treatment, Heart palpitations cure, Ventricular ectopics, Heart disease symptoms, Heart racing, Heart flutter causes, Heart palpitations at night

Id: p_a4yoasfsc

Length: 9min 26sec (566 seconds)

Published: Tue Jun 16 2015