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treatment for premature atrial contractions
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treatment for premature atrial contractions

I am a 28y/o female.  The last couple of years I have been having pac's. I have had all the cardiac testing and everything is normal.  Some days I am very symptomatic to the pac's, when they are frequent I feel very weak, and generally feel poor.  I am taking a small dose of beta blocker, and this week my doctor prescribed digoxin for the pac's.  I have been doing some reading about this medicine and it seems that digoxin is not used for this.  I am now concerned about starting this, what is your take on this medicine? What is your treatment for someone that is symptomatic with pac's?  I appreciate your time and knowledge.
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230125_tn?1193369457
Hi jpcox,


What is your treatment for someone that is symptomatic with pac's?


the first line treatment for PACs is reassurance, like your doctor has done.  They are not harmful and if you can tolerate the symptoms with little or no medications, that is a good option.  Beta blockers may decrease the PACs or decrease the sensation of PACs.  If  you are on a low dose of beta blocker, a higher dose may help.  If you have fatigue from the beta blocker, that usually decreases with time.

There are other rhythm control medications that may help like flecainide and propafenone.  I would not use these medications unless you were extremely symptomatic.

If the PACs are very frequent, ablation is sometimes used as a treatment if they look like they are coming from one location and preferably if they are from the right atrium.  Left atrial PACs can be treated with ablation, but it is a slightly higher risk procedure than right atrial PACs.  They have to be very frequent PACs for this be an option.

I am now concerned about starting this, what is your take on this medicine?
Digoxin is usually reserved for heart rate control and heart failure.  I haven't used it for PACs in the past.

I hope this helps.  Thanks for posting.
12 Comments
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Avatar_n_tn
Dr, thank you for your reply.  This has helped me better understand that even though I am symptomatic to these, they are not going to harm me. Your service on this board is priceless.  
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212161_tn?1391090750
i have pac to, i have been on montors and mine are pac, very few pvc, i get them for weeks at a time,i get them 6-7 a min last holtor i had done i have over 3000 in 24 hours, which is no fun and belive me i felt everyone of them. i have had them since i was 23 now am 48 and still here . they did get to be more since i have gotton older just hope they dont get more than what they are now with age.    yes thank you MD-MJM it means so much for you to tell us we are ok.
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Avatar_n_tn
Can you please describe how your pacs feel, and the symptoms that come along with them.  Do they make you feel physically bad? I had them all day yesterday, and very few today, they have a mind of their own.  When I have them all day, I start thinking maybe my doctor is missing something because I feel so awful.  Would my regular cardiologist know what location my pacs where coiming from, or would I need a specialist? Thanks heartfluttersawayplz!
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Avatar_n_tn
I am a 26 year old guy, I started getting atrial ectopics the day after a particularly strenuous race.  That was about 10 months ago now and I still have them pretty much every day, feel them especially at night (apart from the day I had the Holter of course!)  Echo normal, caught some on ECG but its annoying, I don't know how hard I should keep exercising. I'm also thinking of a trial time drinking no alcohol at all or caffiene.  Not going to stop training though.  
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212161_tn?1391090750
my pac start out as flutters little ones ,than get to feel like bigger flutters. i get 6-7 a min lots of times it feels like one long heart beat but its like a flutter. they are not hard thuds, sometimes they flip but i belive that is my pvc. pac come from the top part of the heart, i went to dr i was having them 24/7 6-7 a min and it was driving me crazy, did the holtor had 3000 in 24 hours, but dr said dont worry about them they are harmless, she told me if i didnt want meds i didnt have to take it for pac, but i also have a really fast heart beat so i have to take something for that. i take timolol its a great old med been on it 15 years , but no matter what i take i always get a break through. and when i do it last for 7-9 weeks all day long than it just goes away. and may not come again for a year or 5-8 months. your cardio dr can tell you where they arte coming from i will ask my dr next time which side they are coming from never heard that before . hope your haveing a pac free day but if not try not, to stress to much about them they will not hurt you , plus mind do not come with stress .food etc they just come when they want to and leave . so stress does not cause mine so far i have found no reason when they start. talk to you soon
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Avatar_n_tn
mine just come on there own as well, nothing seems to trigger them. How fast is your heart beat? Today I have had several pacs, and I am determined not to let them bother me.  
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162069_tn?1224681011
my daughter is 22 and started digoxin about 2 months ago, .125mcg a day. she was noted as having 30,752 pac's during a 24hr holter monitor (she also has dilated cardiomyopathy)  since starting digoxin her episodes are lower by 10,000, and her ejection fraction has improved.  good luck
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212161_tn?1391090750
when i have mine my heart beat is slow around 60 the b blocker i take keeps my heart beating slow i like it that way i cant stand the fast beat. yeah try not to worry. just keep doing what ever you are doing at time they start and dont let them get to you , its like a kid trying to make you mad just say go ahead flip/skip/run all you want you cant hurt me, when i started getting to where i did that ,they came less, yes its scarey and dont work all the time but it helps sometimes, when my dad gets them he jumps on the treadmill and runs, he says he going get them before they get him and it works when hes ran 10-15 mins they are gone. not everything works for every body. hope your having a pac free day.
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Avatar_n_tn
My heart rate is normally 52 with the PACs on top of my resting heart rate, which I haven't been able to measure for ages!  I'm not sure what beta blockers will do for me in that regard - perhaps lower arrhythogenic focus sensitivity to adrenaline but I don't want to take tablets, that would affect sport etc. and just don't like meds.  The main concern is how horrible it feels and thinking at 26, what effect is this going to have on my organs if it goes on for years? Normal beat normal beat wee quick beat.....no beat MASSIVE beat!  Can't be good for the kidneys.
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Avatar_n_tn
i have had pains left side chest ,shoulder blade and left arm for over 6 months, border line high bloodpressure my doc says , no concern, avaerage is 137/98, i was recently diaognosed with heart murmur and premature arterial complex? i was told this is slow heart beat, trouble is still getting these pains more frequently and blood pressure is raised even at rest, history of heart disease in both sides, should i request my GP to get checked properly, headaches and is really now a worry incase i have stroke like my father and brother, who has just died from caridac arrest batteling liver and bowel cancer, not much faith in GP at present and dont know what to do, any advice.
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212161_tn?1391090750
yes you need to go see a cardio dr get all the test ran.i have the pac you have to they are harmless so try not worry about that. but go to a cardio thats the place i would start. good luck .
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