I just want to make sure i communicate a distinction between two different things as explained to me:

There are real heart palpitations which can be a sign of a few different ailments (i think arrthimia is one, and there are 'tachycardia' or some others)

There is a 'Panic/Anxiety attack' sensation which mimics or 'tricks' people into thinking their heart is 'skipping a beat/s'

This latter sensation of a heart 'Palpitation' (and we all seem to use that term) is caused by a few things that happen during a 'fight or flight' panic attack:
- Your heart rate is increasing
- The muscles around your rib cage are tightening (which is around your chest) and they are 'fluttering'.
- Your stomach is (more or less) just below your heart and having blood drawn out (and to the limbs and pectorals) and is undoubtedly shaking, twitching or 'having butterflies' as we say.

This rather wicked little combination of spasms, twitches, butterflies and tightening combined with a racing heart can often convince people that their heart is 'missing beats' or 'skipping beats' or you are having 'heart palpitations'.

I have to believe its possible some poor individual out there is suffering from both at the same time (probably has real Arrhythmia and then 'panics' when it kicks in) so its not an 'either/or' situation..

But

IF you have been to a doctor and had the appropriate tests and its not showing any real physical signs of a real heart condition then you might want to consider its a panic attack sensation you are misinterpreting.
(I can tell you I was definately convinced it was a real 'skipped beat' in my case)

One thing to consider is just exactly when your feeling the 'missed beats'?
Is it when you are anxious and/or having a panic attack?
Then its probably (ask your doc) the 'illusion' or 'sensation' of a missed beat.

If it happens when you are feeling very relaxed or during a moment when you were not anxious or seemingly 'random' times then that is more like an actual heart condition.

Interestingly, that same combination of tightened chest, 'quivering pectorals', 'butterflies in the stomach' can also give panic attack sufferers the sensation their heart is 'RACING like MAD'.... when its not actually going much more than 70-80. (which is rapid yes but not 'bursting out of our chest' speed we think it feels like)

Im going in for a phsyical but its really interesting that i was convinced my blood pressure was 'sky high' but in two tests (and im nervous at docs office too) my blood pressure was described as absolutely perfect.
Not sure what it would read in an actual panic attack though heh.