Premature atrial contraction
Premature atrial contraction | |
12 lead EKG shows Premature Atrial Contractions and bifascicular block (RBBB + LAFB) | |
ICD-10 | I49.1 |
ICD-9 | 427.61 |
MeSH | D018880 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Synonyms and Keywords: PAC; PACs; premature atrial contractions; premature atrial complex; premature atrial complexes; APC; APCs; atrial premature contraction; atrial premature contractions; atrial premature complex; atrial premature complexes; APB; atrial premature beat; atrial premature beats; extrasystole, atrial; premature atrial beat; premature atrial beats; premature supraventricular beat; premature supraventricular beats
Overview
Premature atrial contractions is a benign type of premature heart beat which originates in one of the upper two chambers of the heart (the atria). PACs usually reflect one of the conditions listed in the differential diagnosis of underlying causes below, and the treatment involves removing or treating the underlying cause. PACs are to be distinguished from premature ventricular contractions (PVCs) that originate in one of the lower pumping chambers (the ventricles).
Causes
Common Causes
Causes by Organ System
Causes in Alphabetical Order
{{EndMultiCol}] PrognosisIn general the prognosis of PACs is good, and their occurrence and prognosis is determined by the underlying condition that triggered the PACs. In rare cases, a PAC can, like a PVC, trigger a more serious arrhythmia such as atrial flutter or atrial fibrillation. Unlike PVC's, PAC's generally do not cause hemodynamic compromise because the conduction throughout the AV node and ventricles is normal, and the filling and contraction of the heart is therefore normal. DiagnosisSymptomsThere may be a sense of "a skipped beat" or "a thump in the chest" or neck. In many cases, the person feels nothing. Physical ExaminationPulseThe pulse may feel irregular in a patient who actively has frequent PACs. Laboratory Findings
ElectrocardiogramThe presence of PACs is diagnosed based upon either an EKG, Holter, or Cardiac Event Monitor.
TreatmentRemoval or treatment of the underlying cause of PACs listed in the differential diagnosis is generally sufficient. Beta-blockers may be helpful if the patient remains symptomatic. Additional resources
References |