Auricular Extrasystole: Symptoms, Diagnosis and Treatment


When you notice there is a heartbeat earlier than usual and a fluttery or skipped heartbeat follows with it, it could be a premature atrial contraction (PAC). It may also be called as atrial ectopic beats or atrial premature beats. They are common conditions, and most of the time do not need treatment.

The heart has four chambers. The two upper ones are the “atria.” If your heart’s electrical system triggers an early or extra beat in the atria, it will lead to premature atrial contraction.

A similar condition, premature ventricular contraction (PVC), begins in the lower chambers, which are called the “ventricles” of the heart. Every time your heart goes out of its usual rhythm, doctors call it an “arrhythmia”. There are many different types, including PACs.

Premature atrial beats are caused by a premature and abnormal depolarization of the atria, responsible for an anticipated QRS complex. Generally, the shape of this complex is identical to that of the sinus arrhythmia.


When you have a PAC, you may notice:

  • A flutter in your chest
  • Fatigue after exercise
  • Difficulty in breathing or pain in the chest
  • Dizziness or vertigo


Doctors do not always know the cause. These things can suggest PACs:

  • Pregnancy
  • High blood pressure, heart disease or hyperthyroidism
  • Stress or fatigue
  • Caffeine
  • Alcohol
  • Smoking
  • Medications for cold or hay fever
  • Medicine for asthma
  • Dehydration

In general, premature atrial contractions do not have a clear cause or health risk. In most cases, premature atrial contractions are not a sign of heart disease and only occur naturally.

But some people who have PACs turn out to have related heart conditions, such as:

  • Cardiomyopathy (a weakened heart muscle)
  • Coronary heart disease (deposits of fat in the blood vessels)

If your doctor finds out that you have a condition related to premature heartbeats, you will work together to develop a treatment plan.


When you have single or occasional PACs, there is usually no need to seek medical treatment.

But if you have PACs frequently or if they really bother you, consult a doctor. Based on your symptoms, your doctor may order one or more of these tests:

  • Electrocardiogram, or EKG: this test will show if you have arrhythmia.
  • Holter monitor: a Holter monitor is a small, battery-powered medical device that measures your heart’s activity, such as rate and rhythm. This is a portable version of an EKG that you will use for 1 or 2 days. It tracks all the electrical activity in your heart for your doctor to study.
  • Exercise stress test: this test links you to an electrocardiogram while you are doing physical activity such as running or walking on a treadmill or riding a stationary bike.
  • Echocardiogram: This test uses sound waves to measure how well the heart valves and muscles work.


If the results of your test show that you have other heart-related problems, your doctor will recommend you a treatment plan. However, in most cases, PACs do not need treatment.

When there is little functional tolerance, nerve blockers may be useful. Antiarrhythmic drugs are rarely necessary, but they can be prescribed if there are episodes of paroxysmal atrial fibrillation.

If you have severe symptoms or find them bothersome, treatments may include:

  • Changes in lifestyle
  • Reduce stress, stop smoking, reduce caffeine intake and treat other health problems such as sleep apnea and high blood pressure.

Related Posts:

What Is Supraventricular Tachycardia?

How to Treat Premature Ventricular Contractions (PVCs)?

Arrhythmia: Types, Causes, Symptoms, Diagnosis & Treatments

What Is Tachycardia Arrhythmia?

What Does Sinus Arrhythmia Mean?

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.