Atrial Premature Contractions: Causes and Treatment Options

Atrial premature contraction (APC)

Hello, Director.
I would like to inquire about my previous condition of frequent premature beats (about 300-400 times a day, sometimes over 500).
The doctor switched my medication to take one Concor (1.25 mg) in the morning and one Rhynorm (150 mg) in the evening.
Currently, I don't experience many premature beats, but occasionally, I might have 2-3 episodes over a span of 1-2 weeks.
I would like to ask if this is because the medication dosage is low, which allows for occasional premature beats to occur, or if I should ask the doctor to increase the dosage for better control? Each episode is quite noticeable and uncomfortable.
Is having 2-3 episodes every 1-2 weeks considered acceptable, or is it expected that they will not occur at all? Additionally, does undergoing catheter ablation help with this condition? Thank you, Director.
🙏 Thank you for your assistance.

A-Chang, 20~29 year old female. Ask Date: 2022/03/20

Dr. He Dongjin reply Cardiology

Hello, yes, it's true that the medication is light, so sometimes you may experience 2-3 premature beats every 1-2 weeks.
Would increasing the medication be better? Personally, I believe that having 2-3 premature beats every 1-2 weeks is already quite manageable, and the medication should be at an appropriate level.
Catheter ablation can be helpful, but premature beats are generally considered benign arrhythmias.
I don't think it's necessary to escalate treatment or perform catheter ablation.
This is just my opinion for your reference.
Take care from Changhua Hospital.

Reply Date: 2022/03/20

More Info

Atrial premature contractions (APCs), also known as atrial premature beats (APBs), are early heartbeats originating in the atria of the heart. They can be quite common and may occur in healthy individuals as well as those with underlying heart conditions. Understanding the causes, implications, and treatment options for APCs is crucial for managing this condition effectively.

Causes of Atrial Premature Contractions
APCs can be triggered by various factors, including:
1. Stress and Anxiety: Emotional stress can lead to increased sympathetic nervous system activity, which may provoke APCs.

2. Caffeine and Stimulants: Consumption of caffeine, nicotine, and other stimulants can increase the frequency of APCs.

3. Alcohol: Excessive alcohol intake can irritate the heart and lead to premature contractions.

4. Electrolyte Imbalances: Low levels of potassium, magnesium, or calcium can affect heart rhythm.

5. Medications: Certain medications, including stimulants and some antidepressants, can induce APCs.

6. Underlying Heart Conditions: Structural heart disease, hypertension, or valvular heart disease can predispose individuals to APCs.

Treatment Options
The treatment for APCs often depends on their frequency, symptoms, and underlying causes. Here are some common approaches:
1. Lifestyle Modifications: Reducing caffeine and alcohol intake, managing stress, and ensuring adequate hydration can help minimize APCs.

2. Medication: In cases where APCs are frequent and symptomatic, beta-blockers (like Concor) or calcium channel blockers may be prescribed to help control heart rate and reduce the frequency of premature beats. Your current regimen of Concor (1.25 mg) and Rhynorm (150 mg) seems to be effective, as you mentioned a reduction in the frequency of APCs.

3. Monitoring: Regular follow-ups with your healthcare provider are essential to monitor the frequency and severity of APCs. If they remain infrequent (1-3 times every couple of weeks), this may be considered acceptable, especially if they are not causing significant discomfort.

4. Catheter Ablation: For patients with frequent and symptomatic APCs that do not respond to medication, catheter ablation may be considered. This procedure involves identifying and destroying the tissue responsible for the premature beats, which can provide long-term relief.

Your Current Situation
In your case, experiencing 1-3 APCs every couple of weeks after being on your current medication regimen is relatively common and may not be a cause for concern, especially if they are infrequent and not causing significant discomfort. It is important to communicate with your healthcare provider about your symptoms. If you feel that the APCs are still bothersome or if their frequency increases, discussing the possibility of adjusting your medication or exploring other treatment options, such as ablation, may be warranted.

Conclusion
APCs can be a benign condition, especially when they occur infrequently and are not associated with significant symptoms. Your current treatment appears to be effective, but it's essential to maintain open communication with your healthcare provider regarding any changes in your symptoms. Regular monitoring and lifestyle adjustments can also play a significant role in managing APCs. If you have further concerns or if the frequency of your APCs increases, do not hesitate to reach out to your doctor for a comprehensive evaluation and potential treatment adjustments.

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