Understanding the Risks of Premature Heart Contractions (PACs and PVCs)

A healthy heart beats in a certain rhythm to efficiently pump blood through the body. However, sometimes that rhythm gets disrupted, what we call an arrhythmia. A common type of arrhythmia is a premature heart contraction, which can be either a premature atrial contraction (PAC) or a premature ventricular contraction (PVC).  

Although these conditions are typically harmless, if they’re left untreated, they can sometimes develop significant complications, such as worse arrhythmia or heart damage. Understanding these conditions and getting appropriate treatment is important to living your best life with arrhythmia.  

What’s the Difference between PACs and PVCs? 

The typical human heart has four chambers, arranged basically with two chambers on top and two on the bottom. The top chambers are known as the atria while the bottom two chambers are known as the ventricles.  

Premature heart contractions occur when unusual electrical signals in the heart cause an extra beat from one of your heart’s chambers, disrupting the normal sequence. PACs occur when your irregular heartbeat starts in one of the upper chambers. PVCs occur when your irregular heartbeat starts in one of the lower chambers.  

What Do PACs and PVCs Feel Like? 

PACs and PVCs might not feel like anything. Many people have these irregular heartbeats without ever feeling them. However, if you do feel them, they are likely to feel like your heart is fluttering or skipping a beat. It’s what people often describe as heart palpitations. Most of the time, people can’t tell which heart chamber is beating prematurely. 

In some cases, PACs can come with some additional symptoms, which may be troubling. These can include: 

• Dizziness 

• Feeling like fainting or actually fainting 

• Pounding sensations in the neck 

• Shortness of breath 

• Anxiety 

If these symptoms are severe or unusual for you, it’s probably best to see a doctor quickly—go to the emergency room or urgent care.  

Diagnosing PACs and PVCs 

The typical method for diagnosing PACs and PVCs is monitoring the electrical activity in your heart. The most straightforward way to do this is with an electrocardiogram (ECG or EKG), which is a detailed measurement of your heart’s activity. If you have frequent premature heart contractions, this should detect it. For less frequent premature contractions, you might benefit from using a Holter monitor. This is similar to an EKG, but it’s a little simpler—it doesn’t measure as much detail. However, you also wear a Holter monitor for one or several days, which can make it easier to detect uncommon PACs or PVCs.  

Are PACs and PVCs Dangerous? 

In general, PACs and PVCs are not dangerous. Many people experience them without even knowing it, and they don’t develop any serious complications. However, there are some potential risks of PACs and PVCs.  

Potential risks of PACs include: 

• Development of other heart arrhythmias, such as atrial fibrillation and atrial flutter 

• Stroke 

• Death (if highly frequent) 

As you can see, there are some very serious risks of PACs that justify getting them evaluated and managed when appropriate.  

Potential risks of PVCs include heart damage if the contractions are frequent and persist over a long period of time.  

Treating PACs and PVCs 

If you experience PACs and PVCs, you can make certain lifestyle changes to reduce your risks from them. This includes:

• Quitting smoking 

• Getting appropriate exercise for your heart health 

• Reducing consumption of alcohol and caffeine 

• Controlling blood pressure 

• Managing stress 

• Getting good sleep 

All generally good things for your heart, and they will not only limit the frequency of your PACs and PVCs, but they can reduce your risk of serious complications from them.  

If your cardiologist determines that your PACs or PVCs merit treatment, they might recommend: 

• Medications: blood pressure medications and anti-arrhythmic medications are sometimes used to manage PACs and PVCs 

• Procedures: if your irregular heartbeat is putting you at risk, your cardiologist might recommend a pacemaker or cardiac ablation. In cardiac ablation, a doctor removes the areas of the heart where electrical signals for irregular heartbeats originate.  

Often, these treatments are only necessary if you have other heart conditions in addition to your PACs and PVCs.  

Visit the Nation’s First Arrhythmia Clinic for Help with PACs and PVCs 

South Denver Cardiology is a world leader in the treatment of heart arrhythmias. Our electrophysiology department delivers outstanding care utilizing advanced treatments. Check out our list of achievements, and you will see that we are on the leading edge of arrhythmia treatment in the world. We are also home to the nation’s first dedicated Arrhythmia Clinic for treating PACs, PVCs, and other types of heart arrhythmias.  

Although we are known for our advanced technology, we are also firm believers in never utilizing unnecessary treatments. If your condition is best managed with lifestyle changes, that’s what we’ll recommend, including helping through participation in programs at our medical gym, mind/body studio, and more. When you work with South Denver Cardiology, we will recommend treatments based on your current health and health goals.  

Please talk to your doctor about a referral to our clinic or contact us for an appointment at one of our seven locations.  

 

Premature Heart Contractions (PACs and PVCs): Frequently Asked Questions 

Q: What’s the difference between PACs and PVCs?

A: PACs (premature atrial contractions) and PVCs (premature ventricular contractions) are both extra heartbeats caused by unusual electrical signals in the heart. PACs originate in the heart’s upper chambers (the atria), while PVCs originate in the lower chambers (the ventricles). 

Q: What do PACs and PVCs feel like?

A: Many people don’t feel PACs or PVCs at all. When they are noticeable, they typically feel like the heart is fluttering or skipping a beat, commonly described as heart palpitations. Most people can’t tell whether the sensation is coming from the upper or lower heart chambers. 

Q: Are PACs and PVCs dangerous?

A: In general, PACs and PVCs are not dangerous, and many people have them without knowing it or developing complications. However, PACs carry some risk of leading to other arrhythmias like atrial fibrillation or atrial flutter, and, if highly frequent, can carry a risk of death. Frequent, persistent PVCs can cause heart damage over time. 

Q: When should you see a doctor for PACs or PVCs?

A: See a doctor promptly, or go to the emergency room or urgent care, if PACs come with severe or unusual symptoms such as dizziness, fainting or feeling faint, pounding sensations in the neck, shortness of breath, or anxiety. 

Q: How are PACs and PVCs diagnosed?

A: Diagnosis is typically done by monitoring the heart’s electrical activity. An electrocardiogram (ECG or EKG) provides detailed measurement over a short period and can catch frequent premature contractions. A Holter monitor, worn for one or several days, offers less detail but is better at catching less frequent PACs or PVCs. 

Q: How are PACs and PVCs treated?

A: Treatment often starts with lifestyle changes: quitting smoking, getting appropriate exercise, reducing alcohol and caffeine, controlling blood pressure, managing stress, and improving sleep. When treatment is needed, cardiologists may prescribe blood pressure or anti-arrhythmic medications, or recommend procedures such as a pacemaker or cardiac ablation, which removes the heart tissue generating the irregular signals. 

Q: Where can you get specialized care for PACs and PVCs?

A: South Denver Cardiology is home to the nation’s first dedicated Arrhythmia Clinic, treating PACs, PVCs, and other heart arrhythmias through its electrophysiology department, with appointments available at seven locations.