Can ectopic heartbeat indicate a severe medical condition?

Hello doctor,

I am a 35 year old male weighing 218 pounds. I have a blood pressure of 110/75 mm of Hg, a resting heart rate of 60 to 70 bpm, and a total cholesterol level of 118 mg/dL. I suffer from anxiety and gastroesophageal reflux disease. I take Zoloft 150 mg and multivitamins daily but was previously on Zoloft 100 mg. I do not have a habit of using tobacco, am an infrequent drinker, and consume coffee intermittently. I underwent several tests for the past three to four months. I have undergone an in-office assessment of 12 lead ECG (Echocardiograms) three months back. Additionally, I had a stress test while exercising, and it came out normal with no signs of cardiac arrhythmia or premature ventricular contraction (PVC). I had routine blood work and lipid profile done, the reports were normal, and my total lipids were 118 mg/dL.

Premature atrial contractions (PACs) or isolated PVCs have been observed in me throughout the day. When I record readings with my consumer ECG, they occasionally seem different from one another. I have a long-standing history of anxiety, and my concern with my heart has caused me more anxiety over the past few months. Though I know this is a habit I am trying to break, I have gotten into the habit of wearing the consumer ECG for prolonged periods to catch these beats. I rarely felt them until recently, but now every few days or so I feel a little dropping feeling in my stomach. Sometimes, it happens when I am exercising either once or twice. My primary care physician, who ordered my tests, has said these beats are common in healthy hearts, and I am alright. I asked for a Holter monitor, but he said that was unnecessary and did not order one. He also said these are rare, so they have not shown up on any testing. I do not need something like a beta blocker since it would cause me other side effects. I still worry that I might be missing something important, so I wanted to question you as a specialist. Is there anything at all to be worried about? I feel anxious that this is a sign that something worse is taxing my life. Do I really not need a Holter monitor or any additional testing? I would like to quit worrying about my health, stop attempting to use an ECG on myself, and concentrate on my anxiety, but lately, my worrying has gotten out of control and is taking over my life. It has also made me afraid to exercise. I have attached information on the ectopic heartbeat captured, ten hours of recording around the beat, a copy of echo reports, and stress test results (attachment removed to protect the patient’s identity). Please help.

Thank you.

Hello doctor,

Thank you for the reply.

I avoid almost all caffeine and do not drink or smoke. I have been trying to concentrate on reducing my anxiety by adjusting my medication, going for daily walks, and changing my diet to continue losing weight. I just really struggle with the fear this might be indicative of a developing problem, so I appreciate the information. As for the Holter, my doctor said I did not need one because they are so infrequent and because my other tests all came back normal, with no evidence of ectopic beats. Is it a good opinion? I would like to stop seeing the doctor and focus on my anxiety. Even with my high anxiety I usually only get one to three ectopic beats like this daily. Sometimes, it is the PACs (premature atrial contraction) or PVC (premature ventricular contraction). Is it ok that I get both? My doctor said nearly everybody gets a few of these daily, and I am only likely noticing them because of my anxiety. He said it is uncommon for somebody to get a Holter monitor and not have at least a couple of these beats.