Premature atrial contraction

Premature atrial contraction
Other names	Supraventricular extra systole (SVES), Supraventricular ectopy (SVE)
Two PACs with a compensatory pause seen on an EKG rhythm strip. A "skipped beat" occurs and rhythm resumes 2 P-to-P intervals after the last normal sinus beat.
Specialty	Cardiology, electrophysiology

Premature atrial contraction (PAC), also known as atrial premature complexes (APC) or atrial premature beats (APB), are a common

The exact cause of PACs is unclear; while several predisposing conditions exist, single isolated PACs commonly occur in healthy young and elderly people. Elderly people that get PACs usually don't need any further attention besides follow ups due to unclear evidence.[2]^[3]

PACs are often completely asymptomatic and may be noted only with Holter monitoring, but occasionally they can be perceived as a skipped beat or a jolt in the chest. In most cases, no treatment other than reassurance is needed for PACs, although medications such as beta blockers can reduce the frequency of symptomatic PACs.^[4]

Risk factors

Hypertension, or abnormally high blood pressure, often signifies an elevated level of both psychological and physiological stress. Often, hypertension goes hand in hand with various atrial fibrillations including premature atrial contractions (PACs).^[5] Additional factors that may contribute to spontaneous premature atrial contractions could be:^[4]

• Increased age
• Abnormal body height
• Family history of heart disease
• History of cardiovascular disease (CV)
• Abnormal atrial natriuretic peptide (ANP) levels
• Elevated cholesterol

Diagnosis

Premature atrial contractions are typically diagnosed with an

In some people, PACs occur in a predictable pattern. Two PACs in a row are called doublets and three PACs in a row are triplets. Depending whether there are one, two, or three normal (sinus) beats between each PACs, the rhythm is called atrial bigeminy, trigeminy, or quadrigeminy. If 3 or more consecutive PACs occur in a row and at a frequency of 100 or more beats per minute, it may be called atrial tachycardia.

Treatment

Premature atrial contractions are often benign, requiring no treatment. Occasionally, the patient having the PAC will find these symptoms bothersome, in which case the doctor may treat the PACs. Sometimes the PACs can indicate heart disease or an increased risk for other cardiac arrhythmias. In this case, the underlying cause is treated. Often a beta blocker will be prescribed for symptomatic PACs.^[6]

Prognosis

In otherwise healthy patients, occasional single premature atrial contractions are a common finding and most of times do not indicate any particular health risk. Rarely, in patients with other underlying structural heart problems, PACs can trigger a more serious arrhythmia such as atrial flutter or atrial fibrillation.^[7] In otherwise healthy people, PACs usually disappear with adolescence.^{[citation needed]}

Supraventricular extrasystole

A supraventricular extrasystole (SVES) is an

• Premature junctional contraction
• Premature ventricular contraction

References