Premature Ventricular Contractions (PVCs) and Premature Atrial Contractions (PACs)

About PVCs

Premature ventricular contractions (PVCs) are extra, abnormal heartbeats that begin in the ventricles, or lower pumping chambers, and disrupt your regular heart rhythm, sometimes causing you to feel a skipped beat or palpitations. PVCs — also called also called premature ventricular complexes, ventricular premature beats and extrasystoles — are very common and usually harmless.

Symptoms, Causes and Diagnosis of PVCs

Symptoms of PVCs include a fluttering or flip-flop feeling in the chest, pounding or jumping heart rate, skipped beats and palpitations, or an increased awareness of your heartbeat.

Your heart’s normal, or sinus, rhythm is controlled by a natural pacemaker, the sinus node, which creates electrical impulses that travel across the atria to the ventricles, causing them to contract and pump blood out to your lungs and body in what is known as normal sinus rhythm.

PVCs occur when ventricle contractions beat sooner than the next expected regular heartbeat, often interrupting the normal order of pumping. The extra beat is followed by a stronger heartbeat, which creates the feeling of a skipped beat or a flutter. These extra beats are usually less effective in pumping blood throughout the body.

PVCs can be caused or triggered by:

  • Heart disease or scarring, which can interfere with the normal electrical impulses
  • Low blood oxygen, which could happen if you have chronic obstructive pulmonary disease (COPD) or pneumonia
  • Some medications, including decongestants
  • Elevated levels of adrenaline, which could be caused by caffeine, exercise or anxiety
  • High blood pressure
  • Alcohol
  • Anemia
  • Tobacco use

PVCs may be diagnosed during an electrocardiogram (ECG), which is a routine heart test, or through a portable ECG such as a Holter monitor, a portable device worn for a period of time to capture abnormal heart rhythms.

Prevention and Treatment

Tell your doctor of any symptoms of PVCs so you can determine if there is an underlying cause that needs to be treated, such as other rhythm problems, serious heart problems, anxiety, anemia or infections. You should also report any symptoms such as dizziness or fainting.

In those with healthy hearts, occasional PVCs are harmless and usually resolve on their own without treatment. Some PVC symptoms can be managed through lifestyle changes — limiting caffeine, tobacco and alcohol and stress, for example.

Treatment for patients who experience PVCs on a regular basis includes medication such as beta blockers and calcium blockers. For patients whose symptoms are severe, a catheter ablation may be recommended. During catheter ablation, an electrophysiologist uses radiofrequency energy to cauterize the area of the heart where the PVCs originate.

In patients with heart problems such as heart failure or heart disease, PVCs may be a sign of a more dangerous heart rhythm to come.

For more information about PVCs, visit our Health Library article on premature ventricular contractions.

About PACs

Premature atrial contractions (PACs) are premature heartbeats that are similar to PVCs, but occur in the upper chambers of the heart, an area known as the atria.

PACs do not typically cause damage to the heart and can occur in healthy individuals with no known heart disease. 

Patients with PACs often do not experience symptoms and are diagnosed incidentally. Those who do experience symptoms often complain of a skipped heartbeat or extra beat, also known as palpitations. These are caused by the contraction coming prematurely in the heart’s cycle, resulting in an ineffective pulse or heartbeat. These symptoms frequently occur at night or during relaxation, when the heart’s natural pacemaker, the sinus node, slows down. PAC patients may also experience dizziness or chest pain.

Treatment for symptomatic patients includes medications such as beta blockers or calcium blockers.

Make an Appointment

The Arrhythmia Program at the University of Michigan has been a national and international leader in the treatment of arrhythmias for more than 30 years. To schedule an appointment to discuss your heart arrhythmia or other cardiovascular condition, call us at 888-287-1082, email us at CVCCallCtr@med.umich.edu. Visit our Make an Appointment page for more information about what to expect when you call us.