Normal sinus rhythm in people without heart disease or disorders have frequent skipped beats, including repolarizations when there shouldn't be any. If you don't have palpitations, and if a capable device can show you a graphic representation of your heart's activity, you will see gaps, sometimes PACs (premature atrial contractions) and PVCs (Premature ventricular contractions). These, again, are normal, and electrophysiologists won't take a serious look at you until your 'burden' of ectopic beats rises to the 8-10% range. It seems odd, especially when one is uneasy knowing now that one has these ectopic beats, but they are not considered dangerous. Instead, it is tachycardia (ventricular and supraventricular) that require attention and management. Under the umbrella of SVT are flutter and fibrillation. They are not worrisome (except to the 'beneficiary') to the medical community right away, and if the heart rate isn't high, say above 100 BPM. Once the burden rises, or the heart seems content to remain steadfastly at a rate of, say, 115-130, the clinician will want to put you on either rate control or anti-arrhythmic. Virtually never both at the same time.

Blockages are from atherosclerotic plaque. Deposits of cholesterol, usually calcified. They are not caused by arrhythmias, but they MAY CAUSE arrhythmias. I had an angiogram a month prior to my first catheter ablation for the singular purpose of determining that I had no ischemia, or not much of it. Turns out I am good....at 70.

Plaque is caused by diet, often by transfats and other lipids in excessive amounts in the blood. It gets worse, and piles up, where there is scarring or inflammation in the lining of blood vessels. Some fats, like poor quality/rancid linoleic acids (plant lipids) will lead to more arachidonic acid, a precursor of inflammation.

A complicated subject. Does any of this help?