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Date of last update: 10/20/2017.

Forum Name: Arrhythmias

Question: Ectopic beats and flipped t waves

 Shashachi - Thu Nov 13, 2008 9:49 am


I've had strange sensations in my chest for several years but having visited my GP recently when they became more frequent, I've been told that they are ectopic heartbeats. I'm happy with this and they don't worry me, but I recently learned that my grandmother, who died when I was very young, had a valve defect and died on the operating table from an unrelated arrythmia while she was having a valve replacement. This has got me a bit concerned that the ectopic beats may be related to something more sinister. I've had an ECG which I am awaiting the results of. I also had several traces done at University as I had recurrent episodes of waking up during the night with a heart rate >200bpm, they were all normal except for showing flipped t waves.

What I really want to know is whether I should be concerned about the ectopics and whether the ECG that I had will be sufficient to rule out any problems like those that my grandmother had.
 John Kenyon, CNA - Wed Nov 19, 2008 11:07 pm

User avatar Hi there -

The resting EKG should be able to reveal any truly ominous or troublesome causes of the ectopy, which is almost never problematic anyway, even in most people with actual heart disease. These premature beats are perfectly normal, if alarming, and are almost never of any diagnostic or prognostic significance.

The problem your grandmother experienced was very likely one of those anesthesia-related events which, while rare, are more likely to happen in certain individuals who already have some sort of structural or electrical heart problem.

I would be slightly more concerned about the nocturnal epsisodes of tachycardia in excess of 200 beats per minute that you've experienced. While this likley is totally unrelated to your palpitations, it's not normal. It is not uncommon in otherwise healthy young people, but if it becomes persistent or frequent it can be disruptive and disturbing. When it occurs in conjunction with flipped T-waves it's usually associated with electrolyte depletion, specifically a lack of potassium. Fortunately, this sort of thing can be managed medically (medication to prevent the episodes or potassium supplements if that's the problem) or ablated entirely by minimally invasive catheter procedure. If this becomes an issue you certainly do have options. As far as the ectopic beats, we all have them and if we are aware of them we can try to reduce the factors that can provoke them (such as caffeine, alcohol, tobacco, stress, etc.), but there's always some of this at some times. A lucky few are unaware of them. The rest of us just have to put up with the aggravation. Again, they are almost never significant for anything unless the subject already has serious, symptomatic heart disease.

I hope this is helpful to you.

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