Dear Ma m Thanks for writing to HCM. A skipped beat can have many causes. Most commonly it is caused by extra beats or premature contractions. These are common phenomenon occurring two-third of population on any given day. They do not warrant any work up or treatment if there are no symptoms or structural heart disease. Why surgery was postponed because of a single Extra Beat is not clear to me. If the ECG, X-ray and clinical examination is normal in an asymptomatic patient, then it does not warrant any further work-up. These extra beats can occur due to a variety of known causes and reasons not known to medical sciences. Some known reasons are anxiety , stress, thyroid diseases, tea, coffee, alcohol, tobacco etc.hope this provides some insight. Sincerely Sukhvinder