A certain number of people who suffer from missed beats of their hearts become very much perturbed about the condition of that organ. {236} Irregular heart action, and especially what has been called the irregularly irregular heart, may prove to be a serious condition. There are a number of regular irregularities of heart action, however, consisting particularly of the missed beat at shorter or longer intervals, which may have almost no significance at all. I know two physicians, both athletes when they were at college, who have suffered from a missed heartbeat since their early twenties. In one case it has lasted now for thirty-five years and the physician is still vigorous and hearty, capable even of running up an elevated stairway after a train without any inconvenience. Some twenty years ago there was question of his taking out a twenty-year life insurance policy and the insurance company's physician at first hesitated to accept the risk because of the missed beat. An examination made by three physicians at the home office was followed by his acceptance and he has outlived the maturity of the policy in good health and been given a renewal of it, in spite of the fact that his missed beat still persists. There is often likely to be a good deal of solicitude as to the eventual prognosis in these cases, that is as to what the prospect of {237} prolonged life is. The regularly irregular heart does not seem to make for an unfavorable prognosis. Young patients particularly who have learned that they have a missed heartbeat need to have this fact emphasized. We have the story of an important official of an American university in whom a missed beat was discovered when he was under forty. This was many years ago, and the prognosis of his condition was considered to be rather serious. The patient actually lived, however, for a little more than fifty years after the discovery of his missed beat. It is easy to understand what a favorable effect on a patient solicitous about a missed beat such a story as this will have. It heartens a patient and gives him the will power to throw off his anxieties and to keep from watching his heart and thus further interfering with its activities. There is even a possibility of life to the eighties or, as I have known at least one case, to the nineties, where the irregular heart was first noted under thirty.