What are premature beats and intervals? The normal heart is ordered by the sinus node, which is the supreme commander of the heart. It constantly and regularly sends out electrical signals to every part of the heart, allowing the heart to contract and pump blood normally to maintain circulation. The heart rests for a longer period of time after a premature beat than at other times, which is medically known as compensatory interval. Patients may feel a sudden “hollow” or “top” in their heart, while some patients do not feel any discomfort. How are premature beats diagnosed? If the attacks are frequent, a normal ECG can catch them. If they are infrequent, a better way is to have a 24-hour ambulatory ECG, also called a Holter, which is a box that can be carried on the body, with electrodes attached to the skin of the chest. It is possible to determine the nature (ventricular or atrial), the number, the time of distribution, etc. How are premature beats caused? Premature beats occur in almost every normal person, but more often than not they are a normal electrophysiological phenomenon, which can be triggered by exertion, mood swings, lack of sleep, smoking and drinking coffee. There are also a few cases of idiopathic ventricular premature beats that do not have an underlying organic heart disease. How are premature beats treated? By evaluating the patient’s test results (Holter is the most important) and taking a detailed history, the physician may treat the following: 1. Most cases of episodic premature beats without any organic heart disease do not require treatment, but can be treated by removing the cause and improving the lifestyle. In a small number of cases, short-term treatment with metoprolol (Betaxolol) may be considered. 2. Frequent ventricular premature contractions without organic heart disease should be evaluated by 24-hour ambulatory electrocardiogram, and the doctor may recommend observation or drug treatment according to different conditions. For ventricular premature beats with organic heart disease, the first step is to treat the primary cause to remove the trigger, and the second step is to treat the premature beats themselves, and the specific plan should be implemented by the doctor.