Heart & Cardiology/heart?


For awhile now I've been experiencing a pause in my heartbeat when I'm trying to fall asleep. There is no pain associated with it but it does cause me to panic and get a little anxiety so then my heart begins to race a little. When it happens it feels as if I covered my ears really quick to silence out noise. But I can feel a pause. Its really weird and I'm beginning to get a bit worried. Can you explain what it may be?


Firstly, from the description you give these are most likely benign. Im assuming you don't get symptoms such as dizziness, passing out or shortness of breath with these.

The pause in your heart beat you describe is most likely to be what we call a PVC, a (premature ventricular complex) and they are extremely common. Some people are much more sensitive to these than others.  

Occasional PVC's are extremely common, in fact seen in almost everyone. If infrequent, then generally no testing is indicated. In some they are more frequent. When determining if PVC's are benign, the following is a decent approach. Firstly to look for triggers and rule out underlying causes. An echocardiogram can rule out underlying structural heart disease or heart muscle damage. in some patients exercise stress testing may be performed to characterize the PVC's further. Blood tests can rule out common chemical imbalances. And triggers such as alcohol, caffeine, illicit drugs and stress can be modified to see if they are the problem.

If there is no underlying heart disease and no symptoms then the PVC's are generally not treated as there is no compelling reason to do so. In some patients despite no underlying disease the PVC's are symptomatic and medications or occasionally an ablation procedure may be used to see if they can suppress the PVC's and the symptoms. In a small minority of patients the PVC's are so common (nearly every 2nd or third beat over a prolonged period of time) and there is underlying evidence of heart muscle damage that is thought to be associated. There is some evidence that treating the PVC's may reverse the damage. Those patients typically have thousands and thousands of PVC's per day. At that point electrophysiologists should be involved to characterize the PVC's further and discuss treatment options.

In most people such as yourself, with relatively low burden of PVC's and no evidence of structural or associated heart disease the PVC's are considered generally benign and treatment would only be directed towards symptoms.

Hope that was helpful,  

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Mustafa Ahmed MD


Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease


Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology


Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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