Many patients often tell me they experience sudden, intense heartbeats, followed by palpitations, chest tightness, and dizziness—sometimes even suspecting a heart attack. However, examinations usually reveal nothing serious, as these are typically benign premature beats.

What are premature beats? Normally, our heart beats rhythmically. If an extra beat occurs prematurely, it's called a premature beat. Occasional isolated ones are harmless, but if they happen frequently in succession, they can trigger a series of rapid heartbeats (tachycardia), accompanied by discomfort such as palpitations, heart flutters, or chest tightness.

There are many causes of premature beats, including physiological factors such as recent excessive fatigue, stress, insomnia, heavy smoking or drinking, and consuming strong tea—all of which can lead to transient premature beats, though these are generally benign atrial premature contractions.

Premature beats originating from the atria are called atrial premature beats, while those originating from the ventricles are called ventricular premature beats. Relatively speaking, atrial premature beats are milder because they do not affect the heart's pumping function and can often be alleviated through lifestyle changes.

However, some premature beats are caused by underlying diseases, signaling an abnormality in heart function that requires serious attention. Generally, premature beats exceeding 5 per minute or 30 per hour are considered frequent. If you experience noticeable discomfort that persists after lifestyle adjustments, it is advisable to undergo a 24-hour Holter monitor or cardiac ultrasound at a hospital.

For those concerned about heart attacks, it's important to note that even ventricular premature beats rarely directly cause a heart attack. Their primary risk lies in increasing cardiac workload and potentially triggering more severe arrhythmias. Over time, patients may develop an enlarged heart, reduced cardiac function, and even heart failure.

Let me emphasize how Traditional Chinese Medicine (TCM) addresses ventricular premature beats. In TCM theory, premature beats actually fall under the category of palpitations and cardiac dysrhythmia. Common syndrome patterns include deficiency of both heart and spleen, heart deficiency and timidity, deficiency of both heart qi and yin, and deficiency of both heart qi and blood. Different syndrome patterns require different herbal treatments, but all can achieve good therapeutic effects. Since each individual's condition varies significantly and premature beats represent a complex condition, every patient must receive pattern differentiation-based treatment to ensure the most suitable personalized therapy.