Premature beats (Smarty PANCE)

What are premature beats?

Premature heartbeats are extra heartbeats that result from a depolarizing potential from anywhere in the heart other than the SA node. They can begin in the upper chambers of the heart (premature atrial contractions PACs) the lower chambers (premature ventricular contractions PVCs) or from an ectopic focus within the atrioventricular (AV) junction (premature junctional contractions PJCs)

Early wide "bizarre" QRS, no p wave seen

Premature ventricular contractions (PVCs)

Early, abnormally shaped P wave

Premature atrial contractions (PACs)

Early, narrow QRS complex, usually measured at 0.10 sec or less, no p wave or inverted p wave

Premature junctional contractions (PJC)

Causes of premature beats?

In most cases, premature beats occur naturally and are not a sign of heart disease. But can be caused by heart structural disorders, intoxication, coronary artery disease, and electrolyte imbalances. Potential causes of benign premature contractions may be linked to stress, fatigue, lack of sleep, too much exercise, caffeine or nicotine

Diagnosis of premature beats?

Diagnosed by EKG sometimes Holter monitor testing. Additional testing may include exercise stress testing, electrophysiology study, and echocardiogram

Treatment of premature beats?

Typically requires no treatment. Beta-blockers/calcium channel blockers if symptomatic. Radiofrequency ablation to destroy ectopic focus.

Premature atrial contractions (PACs)

Premature ventricular contractions (PVCs)

Premature junctional contractions (PJC)

Atrial bigeminy

Atrial trigeminy

Ventricular bigeminy

Ventricular trigeminy