Q. Can stress and lack of sleep cause irregular beats in ECG?

Answered by
Dr. Muhammad Zohaib Siddiq
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 05, 2018

Hello doctor,

I have taken my ECG using a device. I have been getting these irregular beats for about a week. Sometimes I think I have been getting some slight chest pain also but not sure if that is a placebo-like effect or not. My uncle who is a doctor thinks they are ectopic beats in relation to lack of sleep and stress.I find myself waking up from breathing related issues frequently often just as I am about to fall asleep. Earlier this week I had a good nights sleep and the heart issue seemed to disappear for that day only. I have made big changes to my lifestyle over the past week as this has really freaked me out. So I am not worried if this is the diagnosis but want to check with a cardiologist.



Welcome to icliniq.com.

These extra beats are called premature ventricular complexes (PVCs) (attachment removed to protect patient identity). Normally heartbeat is caused by an electric current in microvolts. That current is generated in an area of the heart called the sinus node. That current travels from one part of the heart to other parts, that is, from atria to ventricles. Not only sinus node but also other parts including ventricles generate currents too but that is not evident on ECG because that is canceled by currents coming from the sinus node. Sometimes when sinus node current bursts are slowed or ventricular tissue is irritated, ventricles generate current and that travels up the whole ventricle and ventricle contracts and that is called a premature ventricular contraction.

In fit and young people, some PVCs are a normal occurrence and are of no concern. Other common causes, as your uncle said, are anxiety, excessive use of coffee, tea or some medications. In your ECG, your heart rate is between 50 and 60, that is normal in young fit people at rest, so some PVCs may appear. Mostly such PVCs occur on rest when the heart rate is slow, when heart rate raises such as during walking or exercise, PVCs disappear, that is normal. I would recommend to avoid anxiety, refrain from alcohol (if you drink), and tea or coffee may be taken (not excessively). To be on the safe side, a blood test called serum electrolytes may be done, in which we will see potassium levels (low or high potassium levels may cause some heart rhythm problems).

To summarize, no need to worry, it is normal. Further, on follow up, please provide the following information, so that I may guide you more. A complete 12 leads ECG. Is there any family history of sudden death, or heart attack especially in first degree relatives? Is there any history of loss of consciousness?

Thank you doctor,

This is a great help. I have a cardiologist appointment soon, so will get a real ECG then. I just wanted to make sure it was not urgent before the weekend.

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