Today I want to talk about ectopic heartbeats — something that causes a great deal of anxiety, despite being very common and, in the vast majority of cases, completely harmless.

What are ectopic heartbeats?

Ectopic heartbeats are extra beats that interrupt the heart’s normal rhythm. Patients describe them in many ways:

  • a missed beat
  • a flutter
  • a skipped beat
  • or a sudden, forceful “thud” in the chest

A very typical description goes something like this:

“My heart is beating normally… then it feels like it stops… then boom — a big thud — and everything goes back to normal.”

That sensation can be unsettling, even frightening. And understandably, many people worry that something serious may be wrong with their heart.

 

What usually happens next

Most patients sensibly see their doctor. Investigations are arranged — often an ECG, a Holter monitor, and an echocardiogram. If these tests show no structural heart disease and simply confirm ectopic beats, the patient is reassured and discharged.

But here’s the important part:

many patients continue to struggle, even after being told everything is “normal.”

Why? Because ectopic beats feel like the heart has briefly stopped. And that naturally leads to a worrying question:

“If this keeps happening, could it be damaging my heart?”

That uncertainty fuels stress and anxiety — and anxiety itself can actually increase the frequency of ectopic beats. A vicious cycle develops.

 

How the heart actually works during an ectopic beat

The heart is a pump. Its job is to deliver oxygen-rich blood to the body. It works best when it beats regularly and at an appropriate rate.

Any rhythm disturbance makes the heart slightly less efficient — but only for the duration of that disturbance.

 

Here’s what’s really happening during an ectopic beat:

  1. The heart contracts normally.
  2. It starts to relax and fill with blood.
  3. An early extra beat occurs — before the heart has fully filled.
  4. Because filling time was short, less blood is pumped out.
  • This is why it feels like a “missed beat.”
  1. The next beat arrives slightly later.
  2. The heart has had more time to fill.
  3. More blood is pumped out, creating the characteristic thud.

 

That strong beat doesn’t just compensate — it more than compensates for the weaker one before it. And immediately after that, everything returns to normal.

 

Why ectopic beats do NOT damage the heart?

For damage to occur, the body needs to be deprived of oxygen-rich blood for a sustained period of time. Cells don’t suffer harm from brief interruptions — only from prolonged ones.

Ectopic beats are, by definition, non-sustained.

The period of reduced efficiency lasts a fraction of a second. The moment you feel that thud, you know the inefficiency is already over.

 

An analogy that helps

Imagine briefly pressing on your neck.

It’s uncomfortable — but it isn’t dangerous unless the pressure is sustained. If you apply pressure for a second and then release it, you can breathe normally again. You could repeat that many times without harm, provided it never lasts long enough to deprive you of oxygen.

Ectopic beats are exactly the same.

They feel unpleasant for a moment — but that moment is simply too short to cause any damage. In fact, we can comfortably hold our breath or tolerate reduced blood flow for several seconds. An ectopic beat doesn’t even stop blood flow — it merely reduces it slightly, and only briefly.

 

The key takeaway

Ectopic beats:

  • Feel dramatic
  • Feel uncomfortable
  • Can be distressing

But they do not damage the heart.

Damage comes from prolonged, sustained inefficiency — not fleeting, self-correcting rhythm disturbances like ectopic beats.

Often, understanding this fully — rather than receiving rushed reassurance — is enough to reduce symptoms significantly.

 

Final thoughts

Just because something feels unpleasant does not mean it is harming you. Ectopic beats are a perfect example of this.

I hope this explanation helps you understand what you’re feeling and, more importantly, reassures you that your heart is not being damaged.

Thank you very much for reading.

All the best.

 

Keywords: Ectopic heart beats; PVCs; PACs; heart palpitations; heart failure