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Cardiac Arrhythmia: Premature Atrial Contractions (PACs)

Updated on May 31, 2012
Arrow pointing to a reverted p wave showing presence of PAC
Arrow pointing to a reverted p wave showing presence of PAC
  • 24-h Holter examination will confirm the presence, severity and frequency of PACs. It has been shown, that nearly half of the population has PACs and other heartbeat irregularities without concerning consequences.
  • Electrocardigram (ECG) test is usually done during a visit at the family doctor's office or in an emergency room, if there isn't a presence of heart disease and other structural abnormalities, the results will be considered normal.
  • Cardiac event monitor is less likely to be performed, and nothing relevant will be shown if PACs are of benign nature.

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Holter monitorElectrocardiogramA cardiac event monitor
Holter monitor
Holter monitor
A cardiac event monitor
A cardiac event monitor

ECG simulation of PACs

What are PACs

Premature atrial contractions (PACs) are one of the most common heartbeat disorders. PACs are premature beats originating from the atria instead of sinoatrial node, similar to PVCs, PACs unlike normal heartbeat originating from the sinoatrial node, start earlier thus generating a premature beat. This basically means that another location inside the heart geneartes an ectopic beat, thus interfering with normal propagation of the electrical impulse across the heart.

Anything I should worry about?

Premature atrial contractions are present in otherwise healhy individuals, both young and elder people. Usually it doesn't carry any danger, however like every premature beat, it can lead to atrial flutter or atrial fibrillation.

How can I assure that my PACs are benign?

In order to confirm the characteristic of PACs, three methods exist :

  • Holter monitoring
  • ECG
  • Cardiac event monitoring

Symptoms of PACs

Similar to premature ventricular contractions, PACs may be perceived as:

  • A feeling of skipped beat in the chest and/or followed by a strong beat.
  • Palpitations

What can trigger PACs?

Stress, alcohol, caffeine and nicotine intake is the most common factor that can contribute to the frequency and/or occurrence of PACs, avoiding these factors is certainly a good home remedy not only to lower the occurrence of PACs, but it can serve as an efficient indicator of much more severe underlying heart conditions. If none of the factors match, and PACs persist, consulting a doctor is a reasonable option.

Mechanism of PACs

Premature atrial contractions occur when an action potential starts from a point located in the atria and not from the site where the sinoatrial node is located. This generates a premature beat that happens before a normally scheduled beat by SA node.


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