Premature Contractions: Symptoms, Diagnosis, and Risk

One common heart symptom that brings patients to the doctor is the feeling that the heart skipped a beat, which is often caused by a premature contraction of the heart. Sometimes this is a problem that needs treatment, but sometimes it is not. 

The heart is made up of different chambers: the upper chambers, or atria, and the lower chambers, or ventricles. The heart’s sinus node begins a sequence that tells each chamber when to beat. In a normal heartbeat, it goes in a set sequence and produces a coordinated heartbeat. 

Sometimes, a chamber contracts prematurely. This can happen in either the atria or the ventricle and creates an arrhythmia that may require treatment. These arrhythmias are called premature ventricular contractions (PVC) or premature atrial contractions (PAC), depending on where the arrhythmia begins.

Symptoms and risk

Patients with premature contractions can have a sensation of their heart skipping a beat followed by a fluttery heartbeat. Sometimes the premature contraction is not felt at all.

Both types of premature contraction can be influenced by lifestyle factors. Caffeine, alcohol, and stress can increase risk for arrhythmia, while a PVC can be a result of previous heart damage from a heart attack.


Generally, diagnosis begins with an electrocardiogram (ECG) during a doctor’s appointment. Because premature contractions tend to be sporadic, they are often diagnosed with the use of a Holter monitor. A Holter monitor is worn for a period of one to two days and records your heart’s rhythm continuously. You may be asked to document what you were doing throughout the day to help your doctor better understand what is going on with your heart. 


The type of premature contraction determines the proper treatment. Often, PAC occurs sporadically and is not serious. In these cases, no treatment is needed. Occasionally, however, they can be an indication of a more serious problem with your heart that can be diagnosed using  a Holter monitor. If the PAC occurs enough to be bothersome, it may be treated with medication, such as a beta blocker or sodium blocker. 

In PVC, lifestyle changes are usually the first course of treatment. Avoiding caffeine, alcohol, and nicotine can help. If lifestyle changes are not enough, beta blockers and other medications may be used. In severe cases or when medication does not help, doctors may use ablation to treat the PVC. Catheter ablation uses a small catheter equipped with either heat or radiofrequency to ablate, or destroy, the tissue that causes the PVC to occur. 

If you are having symptoms of premature contractions or have been previously diagnosed, reach out to schedule an appointment with one of our Heart Rhythm Institute specialists at Oklahoma Heart Hospital.