Don t worry, a skipped beat can indeed be extremely scary as one begins to fear whether they will suddenly die of a heart attack or go into sudden cardiac arrest. This is not the case: an isolated skipped beat means nothing in a structurally normal heart! There are two main sections of the heart: the atria and ventricles. The atria is the primer pump for the ventricles and pump approximately 30% of blood that enters the heart into the ventricles. The right atrium also houses a structure known as the sinus node; the sinus node is a natural pacemaker in the body that initiates and maintains a heart beat, each discharge of electricity creates a heart beat. The frequent autonomic ability of the SA node gives what we know as Normal Sinus Rhythm. A skipped beat occurs when there is another part of the heart that discharges an electrical impulse before the SA node has a chance to fire. This results in a beat following a very fast beat, a pause then normal beats afterwards. There are two types of skipped beats, a PVC and a PAC, both doing basically the same thing, however, a PVC occurs in the ventricles whilst a PAC occurs in the atria. PVC s usually have a larger pause before the next beat as the SA node is not reset. There are several combinations of skipped beats: rhythms known as Bigeminy, Trigeminy, Quadrigeminy, Couplet, Triplet. These, however, are usually seen only in persons with structural heart disease or congenital electrical defects within the heart in a structurally normal heart. These can be found with tests known as an Echocardiogram, where a probe is placed over the heart, giving a moving image of the heart, its valves, chambers,etc and an ECG which is a test for the electrical activity in your heart. It is best to go to your doctor to get these tests done, to make sure nothing is wrong. All of us have skipped beats, some people can feel them, and others can t: the ones who can usually feel a thump in their chest or neck, or a pause in rhythm feeling as though the heart has stopped beating. None of these are to worry about. The only time to worry is if they happen in a sequence right after each other, this requires medical intervention, but again, this happens in a structurally abnormal heart.