Can ectopic heart beats, PVCs and PACS damage the heart?

Today I wanted to do a video to hopefully reassure patients why ectopic beats do not cause damage to the heart.

The heart is a pump and its role is to get oxygen rich blood to our organs. To function most effectively as a pump the heart has to beat at a certain optimal rate and in a regular rhythm. If the heart goes too slow or too fast it becomes less efficient and less effective. If it beats irregularly it beats less effectively. It therefore is reasonable to say that any heart rhythm disturbance makes the heart beat less effectively but only for the duration of the heart rhythm disturbance. So when we get an extra beat, what is happening is this:


Now as you can see it is not that there is no blood coming out of the heart during the extra beat. It is just that there is less blood coming out of the heart at that time but the next beat that comes along a little later and is felt as thud, more than compensates and essentially terminates that very transient period of inefficiency.

For damage to occur, there has to be a sustained lack of blood going around the body which would then mean that the cells within our organs would starve of oxygen and eventually die. In ectopics beats by definition are nonsustained. The period of inefficiency is so transient that it is simply not long enough to cause harm. The minute you get the thud, you know that the period of inefficiency is over.

Let me demonstrate this by using an analogy.

Imagine someone compressing my neck. Sure it feels uncomfortable but it is not dangerous, unless I compress the neck for a sustained period of time. If I compress the neck for less than a second and let go then it is highly unlikely that I will cause the person to die of suffocation. I could compress the neck as many times as I wish but I will not suffocate the patient unless I keep compressing for a sustained amount of time.

Ectopic heart beats by definition are nonsustained beats and therefore there is not going to be a period of sustained inefficiency and this is why they absolutely do not damage the heart.