What are atrial ectopic beats?

Atrial ectopic beats (AEB) refers to a contraction of the upper heart chamber which occurs before it would be expected. Atrial ectopic beats are also known as premature atrial beats, premature atrial complex (PAC), or atrial extrasystole.

An AEB is usually a harmless disturbance in the normal rhythm of the heart. It can occur only occasionally, in a regular pattern, or several may occur in sequence and then disappear. Most often, the person is unaware of the event.

As people age, extra beats tend to happen more frequently even in perfectly healthy individuals. AEB may be triggered or increased by stress, caffeine, smoking, and some medicines. Cold remedies containing ephedrine or pseudoephedrine have been known to increase the incidence of atrial ectopic beats. AEB may also be the result of an enlarged atria, lung disease, or the result of reduced blood supply to that area of the heart.

If a person is aware of the event, the first symptom of AEB is usually a feeling that the heart has skipped or missed a beat. This is often accompanied by a feeling that the heart is thumping or pounding in the chest. The thumping or pounding is caused by the fact that when there is an AEB, the pause before the next beat is usually longer than normal. The next beat must be stronger than usual to pump the accumulated blood out of the chamber.

Diagnosis of AEB is often suspected on the basis of the patient's description of the occurrence. An electrocardiogram (ECG) can confirm the diagnosis. An ECG shows the heart beat as three wave forms. The first wave is called P, the second is called QRS, and the last is T. An atrial ectopic beat will show up on the ECG as a P wave that occurs closer than usual to the preceding T wave.

Atrial ectopic beats do not usually require treatment. If treatment is necessary because the beats occur frequently and cause intolerable discomfort, the doctor may prescribe medication.

Occasional AEB usually have no significance. If they increase in frequency, they can lead to atrial tachycardia or fibrillation and to a decrease in cardiac output.

AEB cannot usually be prevented. Aggravating factors can be addressed, like excessive stimulants, and uncontrolled pulmonary disorders.