Premature Atrial Contractions

Overview

What are premature atrial contractions?

Premature atrial contractions (PACs) are extra heartbeats that start in the upper chambers of your heart. When the premature, or early, signal tells the heart to contract, there may not be much blood in the heart at that moment. That means there’s not much blood to pump out. A pause and a strong beat may follow the extra heartbeat, making it feel like a skipped beat.

A premature atrial contraction can feel like an extra beat when there’s more blood in the heart to pump than there is with a skipped beat.

Who is at risk for premature atrial contractions?

Anyone can get premature atrial contractions (also known as premature atrial complexes), but they are more likely to happen frequently in people who:

  • Are older adults.
  • Are taller.
  • Have cardiovascular disease.
  • Don’t exercise.
  • Have high HDL cholesterol.
  • Have a higher systolic blood pressure.
  • Don’t drink enough water.
  • Take in excessive caffeine or stimulants.
  • Don’t get adequate or restful sleep.
  • Are very anxious or have high levels of stress.
  • Have electrolyte abnormalities.

How common are premature atrial contractions?

Premature atrial contractions are very common in adults but rare in children born without heart problems.

Symptoms and Causes

What are the symptoms of premature atrial contractions?

You may not have any symptoms. If you do, your symptoms may include heartbeats that:

  • Have a lot of force now and then.
  • Skip.
  • Pound (palpitations).

You may also have anxiety or shortness of breath.

What causes premature atrial contractions?

If your premature atrial contractions happen often, your provider will look for a cause. However, the cause is sometimes unknown.

Causes may include:

  • A drop in the amount of blood going to your heart.
  • Injury to your heart.
  • A problem with your heart’s structure (like hypertrophic cardiomyopathy).
  • A problem with the amount of electrolytes or minerals (like potassium) in your body.

Causes you have some ability to manage include:

Diagnosis and Tests

How are premature atrial contractions diagnosed?

Usually your blood pressure is normal with premature atrial contractions, so sometimes it’s possible for a physician to miss premature atrial contractions during a physical exam.

If you're experiencing premature atrial contractions, your provider may want to order:

  • Electrocardiogram (EKG): If it’s normal, you may not need any other test.
  • Temporary heart monitor: A device you wear to check your heart rhythm over extended periods of time.
  • Echocardiogram: To check your heart’s structure.

Management and Treatment

How are premature atrial contractions treated?

Most of the time, you don’t need treatment for premature atrial contractions unless your symptoms are bad or happen regularly. Your provider can treat the cause if they find one.

Will premature atrial contractions go away?

Yes, premature atrial contractions usually go away without treatment.

What medications/treatments are used to treat premature atrial contractions?

Your provider may treat your premature atrial contractions with:

What are the side effects of the treatment?

Any medicine can have side effects. Talk to your provider if your side effects don’t get better. Like any invasive procedure, catheter ablation carries risks, but providers generally consider it a low-risk procedure.

How do I manage premature atrial contraction symptoms?

You may be able to have fewer premature atrial contractions if you:

  • Exercise regularly.
  • Reduce your intake of alcohol and caffeine.
  • Stop using tobacco products.
  • Avoid dehydration and lack of sleep.

Prevention

How can I reduce my risk of premature atrial contractions?

Some risk factors, like aging, can’t be changed. However, you can:

  • Exercise.
  • Keep your blood pressure under control.
  • Keep your cholesterol under control.
  • Stop smoking or using tobacco products.

How can I prevent premature atrial contractions?

Some things you can do to prevent premature atrial contractions include:

  • Get enough sleep.
  • Drink less caffeine.
  • Limit your use of alcohol.
  • Quit smoking.
  • Manage your stress.
  • Don’t abuse drugs.

Outlook / Prognosis

What can I expect if I have premature atrial contractions?

In most cases, treatment is not needed and the outlook is good. If you’re having premature atrial contractions often, you may be at risk of getting atrial flutter and atrial fibrillation.

What is the outlook for premature atrial contractions?

Your outlook depends on what’s causing your premature atrial contractions. Your provider will look at the conditions you already have when considering your prognosis. For example, your situation is more serious if you have problems with your heart’s structure.

Living With

How do I take care of myself?

Usually, premature atrial contractions will go away by themselves. Pay attention to whether the number of premature atrial contractions you’re having goes up.

When should I see my healthcare provider?

You should make an appointment if your symptoms continue or get worse.

What questions should I ask my doctor?

  • Do you know what’s causing my premature atrial contractions?
  • Do you recommend treatment for me?
  • How often do I need checkups?

Frequently Asked Questions

Are premature atrial contractions the same as atrial fibrillation?

No. Atrial fibrillation is a more serious heart rhythm disturbance with an irregular heartbeat.

Should I be concerned about premature atrial contractions in pregnancy?

No. Premature atrial contractions in pregnancy are common. They normally stop by themselves and do not need treatment.

What’s the difference between premature atrial contractions and premature ventricular contractions?

They start in different parts of your heart. Premature atrial contractions start in your atria. Premature ventricular contractions start in your ventricles.

A note from Cleveland Clinic

Premature atrial contractions are usually not a cause for concern. But you should check in with your provider if the number of premature atrial contractions you have increases. Because premature atrial contractions can predict more dangerous heart conditions, be sure to go to all of your regular checkups with your provider.

Last reviewed by a Cleveland Clinic medical professional on 07/27/2021.

References

  • American Heart Association. Premature Contractions ― PACs and PVCs. (https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/premature-contractions-pacs-and-pvcs) Accessed 9/3/2021.
  • Conen D, Adam M, Roche F. Premature atrial contractions in the general population: frequency and risk factors. (https://pubmed.ncbi.nlm.nih.gov/23048073/) Circulation. 2012;126(19):2302-8. Accessed 9/3/2021.
  • Heart Rhythm Society. Skipped Beats. (https://upbeat.org/early-warning-signs/skipped-beats) Accessed 9/3/2021.
  • Heaton J, Yandrapalli S. StatPearls. Premature Atrial Contractions. (https://www.ncbi.nlm.nih.gov/books/NBK559204/) Treasure Island (FL): StatPearls Publishing. 2021 Jan. Accessed 9/3/2021.
  • Jaeggi E, Ohman A. Fetal and Neonatal Arrhythmias. (https://pubmed.ncbi.nlm.nih.gov/26876124/) Clin Perinatol. 2016;43(1):99-112. Accessed 9/3/2021.
  • MedlinePlus. Ectopic heartbeat. (https://medlineplus.gov/ency/article/001100.htm) Accessed 9/3/2021.

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