Test didn't put my mind at rest over erratic heart beat

Q I've been having occasional bouts of palpitations recently, so my GP arranged for me to have an ECG, which showed I have occasional ectopic beats, though I didn't have any palpitations when it was done. My GP said these are nothing to worry about, but that's easier said than done and I wasn't offered any treatment. What should I do?

- Dr Rosemary Leonard

A The way the heart works is controlled by electrical pathways within the heart muscle. First the upper chambers, or atria, contract, pushing blood into the lower chambers, or ventricles, and a signal then goes to them to contract, pushing blood into the lungs and the rest of the body. It’s this action that can be felt as a heartbeat.

Though the heartbeat is normally regular, having a few irregular contractions of the ventricles is quite common, and most people are unaware that they are happening. As long as they account for less than 10% of overall heart beats, they are usually nothing to worry about.

More frequent odd beats, though, can be felt as palpitations, or as if your heart is missing beats, and this understandably can be alarming, and though they may be caused by anxiety, stress, or excess caffeine or alcohol, sometimes a fault in the electrical pathway is to blame.

Because they can happen erratically, they are often not picked up by a standard ECG, which only gives a very short recording of heart activity, and it sounds as if this is what happened in your case.

A longer recording, over one or three days (depending on how often you tend to get palpitations) may be required, which your GP can arrange for you. This will then hopefully identify any changes in the electrical activity of the heart that occur when you are having symptoms.