Brief Answer:
Can stop drug / Investigations as needed only

Detailed Answer:
Dear Mr XXXX,

Most drug effects start in a few minutes to hours and last for hours to days only.
Since you have no other problem and have had only one episode, you can try stopping the drug.
You are taking a small dose only …
The dose of Metoprolol is up to 200 mg.
These drugs (Beta blockers) are NOT stopped abruptly.
Change it to 25 mg (need not be XL = extended release) twice daily for 2 days; then 12.5 mg twice for 2 days; then 12.5 mg once for 2 days and stop
Discuss with your Primary Care Provider before doing…
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These beats are rather common; at times occurs in normal people.
A single episode – as in your case – need not be aggressively investigated.
They are generally done, when there are recurrent and/or causing serious symptoms…

- A thorough history and repeat physical examination is the next step -
- Repeat ECG (Electrocardiogram / EKG) – Routine 12-lead – is part of clinical examination.
- HOLTER (24 to 48 hour ambulatory monitoring) is done to analyse and plan for further management, if a routine ECG does not show. If no clues, an Event monitoring may be done... Holter records for days; Event Monitor for weeks… Holter records continuously; Event Monitor only at certain times
- ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality) / clots...
- TMT (Treadmill exercise ECG) may be with thallium isotope – is necessary to evaluate ischemia (reduced blood flow / Coronary Artery Disease)

- If there are no clues and if the problem is still bothering to the extent of interfering with life style, there are advanced techniques of investigations of increasing complexity – Electro Physiological Studies (EPS) > it resembles angio > a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on.
There are other advanced treatment modalities - like ablation (thermal or radio-frequency), which could be done during EPS.
Though the test is the gold standard, it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST.
The treating doctor may suggest them depending on need, based on his assessment of the situation.

Too long? / Let me sum up –
Forget & Enjoy life
You can taper off the drug
“Watchful expectancy and masterly inactivity” is all that is needed at present

Good luck
God bless you

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