Lynn, a 64 year old woman has episodes of palpitations that she describes as her “heart missing a beat”. These are intermittent and most often noticeable at night. The episodes can continue for many hours. She often has an elevated heart rate during these episodes. It seems to precipitate a cough. The episodes result in anxiety about her heart health. She was advised that ECG showed ectopic beats, but with her more frequent and prolonged episodes she has never had ECG confirmation of the episodes. I recommended she acquire an ecgme device from www.biosigdx.com to provide her with the confidence of recording her heart rhythm, so as to provide herself with reassurance. Some months later, she returned to see me with multiple recordings on her “ecgme” device that show atrial and ventricular ectopic beats during her episodes of palpitations. One recording shows a sinus pause of a few seconds duration. We discussed the benign nature of her ectopic beats, which she feels will go a long way to reducing her anxiety. She was advised that asymptomatic and infrequent brief pauses are of no immediate concern, but if these become longer or symptomatic, she will require permanent pacemaker.