Heart & Cardiology/irregular heartbeat


QUESTION: Mr. Richardson,
         OK so I had an irregular heartbeat that lasted just a couple of seconds .. it went something like this: two fast beats,regular beat then a skip then thump.then two fast beats skip two fast ones then a skip n thump again and them normal..am I OK?

ANSWER: Hello Tracy,

Yes, you're OK.  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.   The fast beats are premature beats, and the skip is too, just a premature beat too early to pump any blood so it feels like a skip.  The big thump is the heart giving an extra large beat to make up for the skip.

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

David Richardson

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QUESTION: So could u answer 3 very important questions ..#1) why wont my EP Dr not do an EP study on me even if I've had 5 pvcs in a row.? #2) how come everything I read on the internet about pvcs in runs of 3 or more does it say its dangerous and cause for concern but my EP Dr is not concerned. #3) what do u think I should do differently cause I'm really tired of all my premature beats and I feel I will die of sudden death.


1) You don't need an EP study.  Your PVCs are normal heart activity, even 5 in a row.  The only reason for EP study is ablation, which is difficult and often fails for PVCs.

2) Only sustained Vtach needs EP treatment, and only if it's frequent or prolonged.  5 in a row is not dangerous for someone with normal QT and echo.

3) You will not die of sudden death, tho of course your fear is quite real.  It's just the rest of us know you'll be okay.  Get an echo if you haven't already, check with your doc that your QT interval is okay, try a beta blocker if you haven't already, and if that's no help, consider flecainide and sotalol, more effective in reducing PVCs and safe in someone with a normal QT and echo.

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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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