Premature Atrial Contractions

ECG Features

Figure 1: ECG Strip^[1]

A premature atrial contraction (PAC) or atrial premature contraction is "a premature beat arising from an ectopic focus within the atria."^[2]Premature contractions are classified by their origin: atrial (PACs), junctional (PJCs), or ventricular (PVCs).

Table 1: ECG Characteristics^[3]

Clinical Significance^[4]

PACs are a normal electrophysiological phenomenon and do not usually require any treatment. Patients with PACs complain of palpitations and "a sense of the heart 'skipping a beat.' "
PACs mostly occur in healthy individuals without heart disease. Stress or stimulants such as caffeine, tobacco, and alcohol can increase the frequency of PACs. Although seldom, PACs can also be a sign of underlying heart condition in the atrium.
Although most PACs are benign, they may change into atrial flutter, atrial fibrillation, or supraventricular tachycardia.

ECM Features

Figure 2: ECM Analysis, Record 112^[5][6]

ECM Examples

1. Additional Examples of PACs (19)

2. Aberrated PACs

Figure 3: Record 113^[5][6]

Figure 4: Record 202^[5][6]

Figure 5: Record 213^[5][6]

3. Blocked PACs (Non-conducted P-wave) (4)

Additional Information

Diagnosis of PACs on the ECG

References

Premature Atrial Complex [Online image]. (2013). Retrieved July 19, 2016, from http://www.practicalclinicalskills.com/ekg-reference-guide-details?lessonID=12
Premature Atrial Complex (PAC). (n.d.). Retrieved July 27, 2016, from http://lifeinthefastlane.com/ecg-library/premature-atrial-complex-pac/
Premature Atrial Complex. (n.d.). Retrieved July 27, 2016, from http://www.practicalclinicalskills.com/ekg-reference-guide-details?lessonID=12
Premature Atrial Contractions (PACs). (n.d.). Retrieved July 29, 2016, from http://www.cardiachealth.org/premature-atrial-contractions-pacs
MIT-BIH Arrhythmia Database. (1980). Retrieved June, 2016, from https://physionet.org/physiobank/database/mitdb/
Goldberger AL, Amaral LAN, Glass L, Hausdorff JM, Ivanov PCh, Mark RG, Mietus JE, Moody GB, Peng C-K, Stanley HE. PhysioBank, PhysioToolkit, and PhysioNet: Components of a New Research Resource for Complex Physiologic Signals. Circulation101(23):e215-e220 [Circulation Electronic Pages;http://circ.ahajournals.org/cgi/content/full/101/23/e215]; 2000 (June 13).

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