PAC question

[bbxx]

So I am wearing a monitor and when I took a deep breath I felt a (blurp). I assumed it was a pvc couplet since i have had them before. When I played the recording over the phone, it sounded different than anything i heard before. So I asked the tech if it was a  pvc couplet and she said she felt it was a pAC couplet, but that when the strip is printed it will look different.
Sooo. my questions are these.
1. If it looks different printed out than on the computer screen, that just seems odd. How sure can I be she can even
   read the thing?
2. I read the following quote below from a ecg blog. It was my understanding that pvcs were the worst thing...and I have usually only ever captured frequent pvcs...couplets... bi..etc... so upon being told it looks like it was a PAC, I googled it and read the quote below. PAC couplets are rare in healthy hearts?

"Atrial couplets can be benign, but are less common in healthy hearts, and should increase suspicion towards onset of atrial fibrillation."

[is_something_wrong]

Sorry for a short reply, just wrote from my iphone before sleep.

To answer your first question, I'm not really sure I understand it, but yes, PACs look different from PVCs on EKG/rhythm strips. PACs will usually look like normal beats, just earlier, but sometimes the PACs are conducted with partial block (branch block) and mimic a PVC. To tell the difference between a wide complex PAC and a PVC, I guess you usually need a doctor specialized in internal medicine (I asked my GP and he doesn't:), except if the P wave is visible. I'm not sure / don't think techs and nurses necessarily know this.

Regarding atrial fibrillation and PACs, of course it's higher probability that a PAC will trigger atrial fibrillation than that a PVC will trigger ventricular fibrillation. I guess the reason PACs are even more benign than PVCs is the product of probability and consequence. The worst thing that may happen from a PAC is a short run of atrial fibrillation which isn't dangerous in itself, but if it happens often or sustains, of course a cardiologist should treat it. How benign the PACs are also depends on their origin, and as I mentioned, if you have a left atrium with some kind of disease, like MVP, hypertrophy caused by high blood pressure, dilation, etc. This is often the "wood" the AF needs to maintain.

PS: This is really too advanced for me, so if you are nervous, ask a physician :)

[bbxx]

Thank you :)

[is_something_wrong]

Pac couplets and triplets are far more common than PVC couplets or triplets. They are common in healthy hearts, and they dont cause AF. AF is like a fire, it needs spark and wood. Pacs may be the sparks but you also need an atrium able to maintain the fibrillation.