Premature Atrial Complex

A single ECG complex that occurs when an electrical impulse starts in the atrium before the next normal
impulse of the sinus node.

Causes:

 Caffeine
 Alcohol
 Nicotine
 Stretched atrial myocardium (as in hypervolemia)
 Anxiety
 Hypokalemia (low potassium level)
 Hypermetabolic states or atrial ischemia
 Injury, or infarction.
 Often seen with sinus tachycardia

Treatment

 If PACs are infrequent, no treatment is necessary.

 If they are frequent (more than 6 per minute), this may herald a worsening disease state or the
onset of more serious dysrhythmias, such as atrial fibrillation.
 Treatment is directed toward the cause

Premature Ventricular Complex

Premature ventricular complex (PVC) is an impulse that starts in a ventricle and is conducted through
the ventricles before the next normal sinus impulse.

PVCs can occur in healthy people, especially with:

 The use of caffeine, nicotine, or alcohol.

 They are also caused by cardiac ischemia or infarction, increased workload on the heart (eg,
exercise, fever, hypervolemia, heart failure, tachycardia) digitalis toxicity, hypoxia, acidosis, or
electrolyte imbalances, especially hypokalemia.

Treatment

 The effect of a PVC depends on its timing in the cardiac cycle and how much blood was in the
ventricles when they contracted. Initial treatment is aimed at correcting the cause, if possible.
 Lidocaine (Xylocaine) is the medication most commonly used for immediate, short-term therapy
 Long-term pharmacotherapy for only PVCs is not indicated.