![]() In the vast majority of the population, including athletes, ectopics are common and safe. If you have ectopics, your cardiologist will do some tests to make sure that there is not an underlying problem with the heart because ectopics can be stimulated by scar or inflammation in the heart and in someone with heart problems (previous heart attack, heart muscle weakness or heart muscle inflammation) then the ectopics need to be taken more seriously. The other setting is ectopics in someone with heart disease. In the likely case that it is then you can be reassured that you are safe and well. It is very important that the cardiologist does tests to make sure that your heart is normal. Ectopics occurring in someone with a normal heart (including in athletes with healthy heart enlargement due to exercise) is a very safe condition. It seems that they may be more common in athletes although the data on this is not 100% clear. Most commonly they occur with no clear reason in someone with a normal heart. This is called a ‘compensatory pause’ and feels like the heart misses a beat, often followed by a much stronger beat as the heart resumes its normal rhythm.Įctopic heart beats can occur in two settings. Often people do not feel the extra beats but rather feel a pause that occurs after the extra beat. ![]() For reasons that we do not understand, some people feel every single beat and find them very bothersome whilst other people do not feel them at all. Approximately 2% of the population have frequent extra heart beats. These heart beats occurring from cells other than the normal pathway are called ‘ectopic beats’. When a cell fires off (depolarises) the electric current travels through the heart to cause the heart to beat. Indeed, the scene where the beating heart is extracted from some poor man’s chest in Indiana Jones is in fact real physiology! A side effect of this important back-up mechanism is that you can have little patches of overly exuberant cells that fire off more frequently than they should. This is important because if the ‘wires’ in the heart become damaged there is a need for a ‘back-up’ or ‘escape’ rhythm to keep you alive. However, every single cell within the heart has the capacity to generate its own electricity and start a new heart beat. ![]() Normally the heart rate is generated by specialised pacemaker cells and the electric current travels down specialised conduction tissue like electrical wires within the heart. Ectopic heart beatsīy far the most common cause of palpitations are due to ‘ectopic beats’. You may feel this as extra heart beats, skipped heart beats or sudden periods of very fast heart beats. We as doctors become more concerned when there is an awareness of a sudden change in heart rhythm. Sometimes, athletes will become more aware of this as they become fitter and less so when they decondition. Athletes may report an awareness of their heart beating whilst resting quietly and particularly when lying on their left side because in this position the heart lies up against the chest wall. Although the heart and blood vessels do not have any sensory nerve fibres to detect this increased amount of blood pumped with every beat, the surrounding tissues that are ‘pushed’ by the heart and blood vessels do have sensory nerves and thus you may feel your pulse. ![]() The heart enlargement is a normal response to physical training and fitness and results in more blood being pumped with every heart beat (called ‘stroke volume’). In these circumstances it is normal to feel a more vigorous and faster pulsation.Īthletes can sometimes become aware of their heart beating due to the combination of heart enlargement and low body fat. There are circumstances where you are more likely to be aware of your heart beat, particularly when the heart is beating more vigorously such as during exercise or when you are stressed or frightened. The heart beats approximately 90,000 times per day and generally people cannot feel this occurring. Palpitations are an awareness of your heart beat. ![]()
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