Q Every so often my pulse feels like it trips or skips a beat. Is this an arrhythmia? (47, teacher)
A That "tripping" sensation may be an ectopic beat, which is common even in healthy people. However, symptoms alone cannot confirm an arrhythmia — an ECG is needed. If it is frequent or comes with dizziness, testing is recommended.
Detailed Answer
"My heart pauses and then thumps" is a typical description of an ectopic (premature) beat. An early beat lengthens the gap before the next one, the heart fills with more blood in the meantime, and the following beat feels forceful. So rather than a beat being skipped, it is actually one extra beat followed by a stronger one.
Ectopic beats occur in people with healthy hearts and increase with poor sleep, caffeine, alcohol and stress. A few a day are usually just observed.
Checking is warranted if they persist for a large part of the day, come with dizziness or fainting, or if you have a history of heart disease. Because the rhythm must be captured while symptoms occur, a 24-hour ECG is useful. Rather than assuming a diagnosis, confirm it with a recording.
Korean Medicine Clinic Perspective
Many patients visit after being told "benign ectopic beats, no treatment needed" yet still feeling unwell. In such cases Korean medicine adjusts sleep, digestion and tension rather than the heart itself. In practice, once sleep settles and digestion eases, the number of beats people notice often falls.
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