Doctors & patients are saying about ''...

" is a great web site for patients, that is unequaled by anything else out there."

Dr. Douglas L. Packer, MD, FHRS, Mayo Clinic, Rochester, MN

"Jill and I put you and your work in our prayers every night. What you do to help people through this [A-Fib] process is really incredible."

Jill and Steve Douglas, East Troy, WI 

“I really appreciate all the information on your website as it allows me to be a better informed patient and to know what questions to ask my EP. 

Faye Spencer, Boise, ID, April 2017

“I think your site has helped a lot of patients.”

Dr. Hugh G. Calkins, MD  Johns Hopkins,
Baltimore, MD

Doctors & patients are saying about 'Beat Your A-Fib'...

"If I had [your book] 10 years ago, it would have saved me 8 years of hell.”

Roy Salmon, Patient, A-Fib Free,
Adelaide, Australia

"This book is incredibly complete and easy-to-understand for anybody. I certainly recommend it for patients who want to know more about atrial fibrillation than what they will learn from doctors...."

Pierre Jaïs, M.D. Professor of Cardiology, Haut-Lévêque Hospital, Bordeaux, France

"Dear Steve, I saw a patient this morning with your book [in hand] and highlights throughout. She loves it and finds it very useful to help her in dealing with atrial fibrillation."

Dr. Wilber Su,
Cavanaugh Heart Center, 
Phoenix, AZ

"...masterful. You managed to combine an encyclopedic compilation of information with the simplicity of presentation that enhances the delivery of the information to the reader. This is not an easy thing to do, but you have been very, very successful at it."

Ira David Levin, heart patient, 
Rome, Italy

"Within the pages of Beat Your A-Fib, Dr. Steve Ryan, PhD, provides a comprehensive guide for persons seeking to find a cure for their Atrial Fibrillation."

Walter Kerwin, MD, Cedars-Sinai Medical Center, Los Angeles, CA

Premature Atrial Contractions (PACs) Predict A-Fib

Premature Atrial Contractions (PACs) Predict A-Fib

PACs Predict A-Fib

by Steve S. Ryan, PhD

Revised 1/9/20


Premature Atrial Contractions (PACs) are generally considered benign. Everybody gets them, not just people with A-Fib. PACs occur when electrically-active tissue in the heart decides to fire off (depolarize) before it has received the signal from the normal pacemaker of the heart, the sinus node.

PACs come from one of the atria (upper chambers of the heart). PACs generate an early beat (ventricular depolarization). They are often referred to as “extra beats” or “skipped beats”. They can cause palpitations and an irregular pulse, but in general they are benign. PACs become more common as we age. PACs (and PVCs) increase with age—from about one per hour in those 50 to 55 years old to 2.6 per hour among those 70 and older.

But PACs Often Precede or Forewarn of an A-Fib Attack

However, studies indicate that PACs often precede or forewarn of an A-Fib attack. A-Fibbers seem to have more problems with these extra beats than normal people. An important study from Dr. Boon-Hor Chong and others from China shows that frequent PACs (more than 100 beats/day) actually predict who will develop A-Fib.

Frequent PACs also predicted who would develop ischemic stroke, congestive heart failure, and death.
The study: 428 patients without A-Fib but with palpitations, dizziness or syncope (fainting) were divided into four groups according to how many PACs they experienced.

The top quartile (107 patients) with more than 100 beats/day were considered to have frequent PACs. (Some patients in this top quartile had much higher rates of PACs than 100 beats/day. The mean number of PACs was 533.5.)

There were no significant differences in gender, diabetes, hypertension or coronary artery disease. But patients with frequent PACs were older and more likely to be smokers. Frequent PACs predicted that someone in the 6.1-year follow-up would develop A-Fib.

Frequent PACs also predicted who would develop ischemic stroke, congestive heart failure, and death. (Other predictors were age, male gender, hypertension, diabetes, and coronary artery disease, as previous studies have demonstrated.) More patients with frequent PACs developed congestive heart failure or died.

Editor’s Comments:
This study is a major medical breakthrough for A-Fib patients. A-Fib is often not diagnosed till it is too late, till complications such as ischemic stroke, congestive heart failure, and death occur. Up to 25% of patients were first diagnosed with A-Fib only at the time they had a stroke. But now we have a documented method of predicting who is more likely to develop A-Fib. (We previously knew that older people and people with coronary artery disease were more prone to develop A-Fib.)
A catheter ablation, in addition to removing A-Fib producing spots in the heart, can also map and ablate areas producing PACs/PVCs.
It’s relatively easy for doctors, using today’s sophisticated and low effort monitoring devices, to determine if someone has a lot of PACs/PVCs. It should become part of a routine physical exam when one turns 50 to monitor for frequent PACs/PVCs. Then preventive measures can be taken such as natural remedies like magnesium, or anticoagulants, devices to close off the Left Atrial Appendage where 90%-95% of A-Fib strokes come from, antiarrhythmic meds, ”Pill-In-The-Pocket” therapies, or a catheter ablation.
A catheter ablation, in addition to removing A-Fib producing spots in the heart, can also map and ablate areas producing PACs/PVCs. Frequent PACs can be as damaging and troublesome as A-Fib. Ablations are done not just to fix A-Fib, but also  for the sole purpose of freeing someone from frequent PACs. They are an option patients with frequent PACs should be aware of.
But one question this study didn’t fully address is how often someone with frequent PACs develops A-Fib (and other heart problems). Frequent PACs is a definite predictor. But how many people or what proportion of people with frequent PACs will definitely develop A-Fib? If you have frequent PACs, what are the odds that you will develop A-Fib, or how soon will you go into A-Fib? (The editor has written Dr. Chong and asked him this question.)
If you have frequent PACs, you shouldn’t try to play the odds and hope you don’t develop A-Fib. Instead you should face the reality that you are on the road to developing A-Fib and act accordingly. Talk with your doctor about what you should do, what preventive measures you can take.
(A special thanks to David Young for calling attention to this research and pointing out its importance for A-Fib patients.)

References for this Article
Citation: Chong, BH et al. “Frequent premature atrial complexes predict new occurrence of atrial fibrillation and adverse cardiovascular events.” Europace (European Society of Cardiology) (2012) 14, 942-947 Last accessed 1/012013 URL doi: 10.1093/europace/eur389

Posted December 2012

Back to top

Return to Index of Articles: Research and Innovations

Last updated: Friday, February 21, 2020

Related Posts

Follow Us
facebook - A-Fib.comtwitter - A-Fib.comlinkedin - A-Fib.compinterest - A-Fib.comYouTube: A-Fib Can be Cured! -

We Need You Help be self-supporting-Use our link to Amazon is a
501(c)(3) Nonprofit

Your support is needed. Every donation helps, even just $1.00. top rated by since 2014 

Home | The A-Fib Coach | Help Support | A-Fib News Archive | Tell Us What You think | Press Room | GuideStar Seal | HON certification | Disclosures | Terms of Use | Privacy Policy