Premature Junctional Contraction

What is a premature junctional contraction?

A premature junctional contraction (PJC) is an early, extra heartbeat. A PJC starts in the junction of the heart, also known as the atrioventricular (AV) junction. The junction is near the middle of the heart between the atria (upper chambers) and ventricles (lower chambers).

PJCs are a type of arrhythmia (irregular heartbeat). The heart typically produces electrical signals that make it beat in a regular rhythm. When you have an arrhythmia, something interferes with these electrical signals. Arrhythmias can cause heartbeats that are:

• Irregular (skipping, extra or uneven beats).
• Too slow (bradycardia).
• Too fast (tachycardia).

Who gets premature junctional contractions?

Most people who get a PJC have heart failure or an existing heart condition. However, PJCs can also happen in healthy hearts.

How common are premature junctional contractions?

PJCs are less common than other types of extra heartbeats, such as premature atrial contractions (PACs) or premature ventricular contractions (PVCs). The most common type of arrhythmia is atrial fibrillation (Afib), which affects at least 2.7 million adults.

How does premature junctional contraction affect me?

If PJCs happen only occasionally, they may not cause any problems. But frequent and regular PJCs can lead to junctional tachycardia, a fast heartbeat that comes from the heart’s junction. Junctional tachycardia may require treatment, such as medication, to slow the heart to a steady pace.

What causes premature junctional contractions?

Causes of PJCs include:

• Digitalis toxicity: Digitalis (digoxin or digitoxin) is a medicine that treats heart failure and arrhythmias. Digitalis toxicity can happen if you take too much of this medicine, or your body can’t process it properly. Digitalis toxicity is the most common cause of PJC.
• Consuming caffeine.
• Coronary artery disease.
• Drinking alcohol.
• Electrolyte
• Hypoxemia.
• Heart failure.
• Smoking or using tobacco products.

What are the symptoms of a premature junctional contraction?

If PJCs don’t happen often, you may not have symptoms. But if you have frequent PJCs, you may notice:

• Fatigue.
• Lightheadedness (feeling like you might faint).
• Heart palpitations.

How are premature junctional contractions diagnosed?

Your healthcare provider will ask you about your symptoms and do a physical examination. They’ll also ask you about your:

• Health history.
• Medications you take.
• Lifestyle, including use of tobacco products, alcohol and caffeine intake.

What tests diagnose premature junctional contractions?

If your provider suspects an arrhythmia, they may perform an electrocardiogram (EKG). This noninvasive test measures and records your heart’s rhythm with electrodes (pads you stick on your chest) and a special computer.

A PJC may show up as a small extra beat on your EKG results, even if your regular heart rhythm is normal. But in some cases, a PJC can “hide” inside the regular heartbeat on an EKG. If an EKG doesn’t provide a clear diagnosis, your provider may recommend further testing, such as:

• Echocardiogram.
• Stress test.
• Tilt table test.

How do doctors treat premature junctional contractions?

Your provider treats the underlying cause of PJCs to restore a regular heart rhythm. Your treatment may include:

• Adjusting your digitalis dose if you currently take this medication.
• Medication to treat digitalis toxicity.
• Medication to treat heart failure or coronary artery disease.
• Lifestyle changes, such as quitting smoking or cutting back on alcohol or caffeine intake.

How can I prevent premature junctional contractions?

You can’t always prevent PJCs. But following a healthy lifestyle and seeing your provider regularly can help keep your heart healthy. Your provider may recommend that you:

• Avoid or limit alcohol. Men and people designated male at birth (DMAB) should consume no more than two drinks per day. Women and people designated female at birth (DFAB) should consume no more than one drink per day.
• Cut back on caffeine from coffee, energy drinks or other sources.
• Don’t smoke or use tobacco products. Quit if you do use tobacco products.
• Eat a healthy diet with plenty of fruits, vegetables and whole grains.
• Get regular exercise, such as walking.
• Manage stress.
• Take medications as prescribed to control other health conditions.

How long will I have premature junctional contractions?

With proper treatment of underlying causes, PJCs may improve or go away.

Are there long-term effects from premature junctional contractions?

An occasional PJC does not damage the heart. If PJCs are caused by another heart condition, see your provider regularly to keep your heart healthy. Regular visits to your provider can help you prevent or minimize long-term effects from heart conditions.

When should I seek medical care for premature junctional contractions?

See your provider if your symptoms change or get worse. Contact your provider if you notice signs of heart failure, such as:

• Dry, hacking cough.
• Fainting.
• Feeling tired or weak during exercise or activity.
• Shortness of breath (dyspnea).
• Swelling in the ankles, legs or abdomen.

A note from Cleveland Clinic

Premature junctional contractions are usually mild and may only require regular checkups with your provider. If you have a heart condition causing PJCs, your provider can recommend an effective treatment. Many people with PJCs live healthy, active lives.