Premature Atrial Contractions (PACs)

What are PACs?

Premature atrial contractions (PACs) are extra beats coming from the top chambers of your heart (atria).  

Why do people get PACs?

PACs can be caused by stress, caffeine, nicotine, alcohol, electrolyte disturbances, structural heart disease, lung disease, sleep apnea, or an unknown cause.  Sometimes they occur for no reason at all.    

Are they Dangerous?

No. 

 Signs & Symptoms of PACs 

• Palpitations (feelings of having fast-beating, fluttering, or pounding heart) 
• Shortness of breath 
• Chest pain, pressure, tightness, or discomfort 

 What should I do if I’m experiencing an episode of PACs

If you’ve had this problem before and it feels similar to past ones, and you feel okay, you can do your normal activities.  Pay attention to how your body feels and rest if you need to. You can try some relaxing exercises like meditation or deep breathing. Take note of how long the problem lasts, how you feel during the episode(s), and if you’re having episodes more or less often than before. Tell your doctor about all these things when you see them next. 

Symptoms of PACs you should call your provider about:  

• Symptoms feel worse than usual, or you start feeling worse  
• Bothersome episode that has lasted longer than 24 hours 

Symptoms of PACs to go to the ER for:
PACs should not cause an ER visit.  That said, if you are experiencing the following symptoms, you may have a different heart rhythm that is more dangerous for which you should go to the ER:  

• Moderate-to-severe chest pain 
• Fainting or feeling like you might faint  
• New-onset shortness of breath or difficulty breathing at rest 
• Signs of Stroke (sudden weakness, numbness, visual changes, facial drooping, difficulty speaking, trouble walking, change in level of alertness, extremely severe headache) 

 How is PACs Diagnosed? 

• Ambulatory Rhythm Monitoring  
• ECG (also called EKG): a non-invasive test that records the heart’s electrical activity for 10 seconds. 
• Wearable Devices: (Link from Heart Rhythm Society)Personal devices that you can use at home to capture a simple ECG such as the Apple Watch or Kardia App.   

 How are Premature Atrial Contractions Treated? 

 Commonly used Medications: metoprolol, carvedilol, atenolol, propranolol, diltiazem, verapamil 

Healthy Lifestyle  

• Stop smoking [links to Colorado Quitline Website:
• Limit caffeine intake: some people find that caffeine can trigger PACs, especially if they drink too much.   
• Limit or stop drinking alcohol: alcohol can trigger PACs and can make it worse.  Avoiding alcohol altogether is best, but if you choose to drink, limit your alcohol intake to less than 2 drinks/day for men or less than 1 drink/day for women.  Changing your relationship with alcohol can be incredibly challenging, and often support is needed.  Talk with your primary care provider about your alcohol intake and habit change goals.  There are also many online and in-person resources including, but not limited to, Alcoholics Anonymous