PREMATURE ATRIAL CONTRACTIONS

As the name suggests, premature atrial contractions (PACs) are contractions in the atria of the heart that occur too early in the rhythm sequence. Abnormal electrical impulses signal the atria to beat prematurely. PACs are very common and can happen in otherwise healthy persons. Most persons who have PACs never notice them. Because PACs occur out of the normal rhythm, this condition is an arrhythmia. The physician may notice an irregular pulse, or the PACs may be found on an electrocardiogram (ECG).

The most common cause of PACs among healthy persons is ingestion of caffeine, nicotine, or alcohol or exposure to stress. PACs are found more frequently among persons with heart disease such as ischemia (decreased blood flow to the heart muscle) or congestive heart failure (decreased pumping efficiency of the heart). Persons with heart disease are more likely to have PACs convert to atrial fibrillation or atrial flutter (two types of atrial arrhythmias). Chronic pulmonary disease may make PACs more frequent, as can electrolyte (salts in the blood) disturbances.

Treatment

Healthy persons with no symptoms of heart or lung disease need no specific treatment. The condition may resolve on its own or may be less frequent if one cuts down on caffeine, alcohol, nicotine, and stress. Persons with PACs can exercise safely and need no special dietary changes other than reductions in alcohol and caffeine. PACs may be controlled with anti-arrhythmic medications, but the main goal is to manage evident heart or lung disease.

The DOs

Reduce your intake of caffeine, alcohol, and nicotine and your exposure to stress, especially if you have heart or lung disease.

The DON'Ts

Do not neglect therapy for heart or lung disease.

When to Call Your Doctor

If you have palpitations (rapid heartbeat), chest pain, shortness of breath, or fainting.

For More Information
Consult a textbook on cardiology at your local library or a medical school in your region. Call the American Heart Association at 1-800-242-8721 and ask for the literature department.

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