Premature Atrial Contractions (PACs) are amongst the most common forms of arrhythmias. It is due to the premature discharge of an electrical impulse in the atrium, causing a premature contraction. Therefore, it is named “premature atrial contraction,” or PAC. A PAC is premature, because the it occurs earlier than the
next regular beat should have occurred. Symptoms of PACs Most often, patients with PACs complain of palpitations. However, rather than reporting a sustained racing heartbeat, they usually describe a “missing” or “skipping” beat. Some patients even feel that the heart has “stopped” while others describe a sensation of “flip-flop.” This is due to the fact that the PAC comes too early (prematurely) in the cardiac cycle to have resulted in an effective pulse or heartbeat. Therefore, no heartbeat is felt until the next regularly-timed heartbeat occurs after a pause (so-called compensatory pause). Incidentally, the beat after the PAC usually occurs with stronger contraction than usual and can be associated with an urge to cough. Symptoms of PACs are virtually indistinguishable from those of PVCs as the physiological effects are identical. Causes of PACs
In the majority of cases, PACs occur in normal healthy individuals without any evidence of heart disease. Stress or stimulants such as tea, coffee, or alcohol can increase the frequency of PACs. In the minority of cases, PACs can be a sign of underlying heart condition in the atrium associated with hypertension or valvular condition. Consequences of PACs The great majority of PACs are completely benign and require little if any treatment at all. As mentioned above, in rare cases, PACs may be the only sign of underlying heart conditions and these should be ruled out with appropriate evaluations. However, PACs may change into
Diagnosis Evaluation is similar as with any patient first seen for palpitations and arrhythmias and includes blood tests, EKGs, as well as echocardiograms. Treatment of PACs As most PACs are benign, treatment is optional and is usually geared toward alleviation of symptoms. Medications such as beta blockers or calcium blockers are often used but with mixed result. Most important treatment, after ruling out severe underlying heart conditions, is patient reassurance and teaching of various coping mechanisms. What are considered frequent PACs?Frequent PAC was defined as more than 720 PAC/24 hr as used for frequent ventricular premature beats.
How many PACs are excessive?An excessive PAC burden, defined as ≥200 PACs/24 hours, was present in 25.6% and 14.7% (p<0.01), of stroke/TIA and control patients, respectively.
What is a high burden of PACs?We subsequently divided our cohort into two groups, i.e. high burden group (PAC ≥ 100 beats per 24 h) and low burden group (PAC < 100 beats per 24 h), to investigate the relative risk in different subgroups (Fig.
When should I be concerned about PACs?They are a type of heart arrhythmia. If you have occasional premature atrial contractions, but you're otherwise healthy, there's probably no reason for concern, and no need for treatment. If you have frequent premature atrial contractions or underlying heart disease, you might need treatment.
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How many pacs are normal in 24 hours
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