A premature heartbeat (contraction) is a type of arrhythmia. It is a beat that occurs earlier than expected, briefly interrupting the normal heart rhythm.

A premature heartbeat is often described as a "thump" in the chest. However, this “missed beat” sensation does not reflect the premature contraction, but rather the forceful beat that follows the pause after the premature beat. The heart fills with blood during this pause, making the next beat more forceful.

Premature beats that occur in the atria (upper chambers of the heart) are called premature atrial contractions, or PACs. Premature beats that occur in the ventricles (lower chambers) are called premature ventricular contractions, or PVCs.

Causes of premature heartbeats

In most cases, premature beats occur naturally and are not a sign of heart disease. But certain underlying heart diseases, such as cardiomyopathy or coronary heart disease, can cause premature beats.

Potential causes of benign (not dangerous to health) premature contractions may be linked to:

• Stress
• Fatigue
• Lack of sleep
• Too much exercise, caffeine or nicotine

Why choose Ohio State for premature heartbeats treatment?

The Electrophysiology Section at Ohio State’s Ross Heart Hospital consists of the largest group of electrophysiologists in central Ohio as well as more than 100 nursing staff members dedicated to the care of patients with heart rhythm problems. The Ross Heart Hospital is home to one of the largest electrophysiology programs in the country utilizing physician experience coupled with advanced mapping and ablation technology to manage the wide spectrum of heart rhythm problems.

How Ohio State diagnoses premature heartbeats

Usually, single premature beats require no treatment. However, when they are frequent or annoying, your doctor may recommend a test to search for their cause.

• Electrocardiogram (EKG/ECG) – The heart's electrical impulses are recorded and measured to indicate the presence of arrhythmia.
• Holter monitor – A portable, battery-operated EKG/ECG that is worn for a day or two and provides your physician with continuous data about the electrical activity of your heart.
• Exercise stress test – A test performed on a treadmill or stationary bicycle to measure heart, lung and muscle function during physical activity. You are attached to an electrocardiogram (EKG/ECG) to record electrical activity of the heart.
• Electrophysiology (EP) study – An invasive test where the doctor inserts pacing wires through a blood vessel into the heart to evaluate the premature beats.
• Echocardiogram (also called echo) – This test uses sound waves to assess the function and structure of the heart muscle and valves.

How Ohio State treats premature heartbeats

Treatment depends on the type and seriousness of your arrhythmia. In some patients, no therapy is required. For patients with severe symptoms, therapies for the premature beats include:

• Lifestyle changes – Minimizing stress, eliminating tobacco and caffeine, and treating other medical problems like high blood pressure and sleep apnea.
• Antiarrhythmic medications – Medications that are specifically designed to help reduce the premature beats.
• Catheter ablation – A technique to permanently eliminate the source of paroxysmal supraventricular tachycardia by using radiofrequency energy.