Hi friend, Welcome to Health Care Magic Irregular heart beats need to be DOCUMENTED by ElectroCardioGram (ECG / EKG). THE FIRST STEP IS TO SEE A CARDIOLOGIST Anxiety / Alcohol / Tobacco (smoking, chewing) / Caffeine (too much coffee, cola) / Medicines like phenylephrine used for ‘cold’ are common causes. Occasionally, there are abnormal nerve paths (bypass tracts) in the heart. It is advisable to have it investigated. A thorough history and physical examination is the first step - Routine 12-lead Electrocardiogram (ECG) is part of clinical examination. If a routine ECG does not show, 24 to 48 hour ambulatory monitoring (Holter) is needed. ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality). Treadmill exercise ECG (TMT) is done to exclude Ischemia (reduced blood flow). Laboratory work-up is routine - like blood counts, sugar, urea, electrolytes (potassium in particular), thyroid (over-active) and so on. Your Internist shall suggest based on the situation. If there are no clues and if you are still bothered by it to the extent of interfering with life style, there are advanced techniques of investigations of increasing complexity (and invasive) – like Electro Physiological Studies (EPS). A specific treatment is no always necessary. The first line medicine is generally beta blockers, like Metoprolol – slow release and small dose. It will benefit both anxiety and missed beats. Your doctor will give proper prescription and follow up They are several other classes of drugs are available – acting by different mechanisms - the specialist will decide tailored to your needs... There are other advanced treatment modalities - like RF ablation, which could be done during EPS. You stand an excellent chance of returning to normalcy. You are tolerating the rate well - means that you may not have any basic disease of the valve, muscle and so on. Be in touch with your doctor - it is a question of time and you will be well. Medicine is well advanced nowadays – management is possible for almost all situations... Take care Wishing speedy recovery God bless Good luck