Hello and thank you for using HCM.I carefully read your question and I understand your concern. You should not worry about this. I will try to explain you something and give you my opinion. You should know that this skipping beats have to do with rhythm issues. There are some electrical impulses that generates from parts of the heart different from normal sinus rhythm.They cause a premature heart contaction that you feel like a skipped beat and you might experience palpitation, flattering sensation, pauses, anxiety, difficulties in breathing deeply. Normaly, when this extra beats are in high frequency than we treat them medicaly.Atenolol is one of the alternatives. As you still feel this extra beats and they are interfering in your daily life than in my opinion we should do some examinations. If I was the treating doctor I would recommend some thinks to find the possible couse like a cardiac echo to evaluate heart function and valves, a full blood analyze to exclude anemia, hyperthyroidism or electrolyte imbalance and a holter rhythm monitoring under Atenolol to see the frequency of this extra beats. After all this we can better judge if it is necesary to do something like rise atenolol dosage or change it whith another anti arythmic drug. Hope I was helpfull. Best regards, Dr.Ervina.