My heart

For the past several months, I've noticed my heart skip a beat sometimes. Or, it feels that way anyway. It's just a half of a second, and then the very next beat, it beats harder, faster and louder. I almost feel like a thud in my chest and my face gets kind of warm and I almost feel a very slight loss of breath. It happens with exertion and also while at rest. This fluttering feeling has caused me to actually take my pulse when it happens, and I do feel my heart beat "pause". When I told the doctor this, he recommended a Holter Monitor. I wore it for 24 hours and I was instructed to write down any "skipped" beats that I noticed and the exact time as to when I noticed them. I did this. When I got the report back, it stated: "Patient was in normal sinus throughout the study. There were 9 premature ventricular contractions and 4 atrial contractions. There was no atrial fibrillation, though the patient reports skipped beats. She was in sinus rhythm with a rate of 80 and 95 respectively." When I asked my doctor about this, she said that the "skipped" beats were not from my heart's electrical system because they were not picked up by the Holter. I asked about the PVCs and PACs, and my doctor said I didn't even feel them because I never wrote anything down when they occured, and that everybody gets these. Is this true? I feel confused. How can my heart's "electrical system" NOT pick up the skipped beat, when I physically take my pulse when it happens and actually feel it being skipped? I guess I don't understand. Apparently I do not have a heart problem because I had a transcatheter procedure, where a cardiologist actually went INSIDE my heart by going through a vein in my groin area to take a look at things. He said my heart looks fine. I'd appreciate your thoughts on this, thank you very much!

[Michael J. McWilliams, M.D.]

PVCs are very common and can cause the systems that you describe.  It is true that atrial fib causes skipped beats. PVCs can cause a similar sensation.  I can't say that the PVCs are what caused your symptoms because I don't have access to your holter or journal, but PVC symptoms are often describes as you have above.

I hope this helps.