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Heart & Cardiology/how do you know if its serious


QUESTION: Dear Doctor
i have lots of missed beats which continue for hours, how do you know if they are harmless miss beats or something more serious? Do i have to have it checked with a 24hr moniter?
Thank you

ANSWER: Hello Dawn,

Skipped beats are normal heart activity, easy to understand as normal from knowledge of the heart's electrical system and occurring in about half of us.  They don't mean you have heart disease or will in the future develop heart disease or any cardiac catastrophe.  A 24-hour monitor won't help much.  It would tell whether the missed beats are atrial or ventricular, but either are safe if you have a normal heart.  Ask for an echocardiogram to be sure your heart's structure and function are normal.

Please write back if this note doesn’t answer all your questions.

David Richardson

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QUESTION: Thank you doctor.
What would they be looking for?
Is it possible that I have fib? I don't know what that is but I have read on here that it needs attention. Does that feel the same as the missed beats? Regards

An echo sees the structure and function of your heart.  That's what they would be looking for.

In afib you feel that your heart rhythm is totally irregular for at least a minute.  Lots of missed beats doesn't sound like atrial fib, but your raising that question suggests getting a 24-hour EKG, called a Holter monitor, if the skips occur every single day, or an event monitor if the skips don't occur every day.

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David Richardson


Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.


Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Circulation, American Heart Journal, Hypertension.

M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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