The heart is made up of two upper chambers (atria) and two lower chambers (ventricles). In a normal heartbeat, an electrical impulse originates from an area in the right atrium called the sinus node. This impulse travels first to the atria, causing them to contract and pump blood into the ventricles. The electrical impulse then continues along its circuit to the ventricles, signaling them to contract and pump blood out to the lungs and the body.
Sometimes, abnormal electrical signals originate from areas of the heart other than the sinus node. These extra impulses may target the atria or the ventricles, causing them to contract out of rhythm with the regular heartbeat. This type of arrhythmia is called a premature contraction.
Premature contractions are common and may even go unnoticed. However, some people report a feeling of the heart skipping a beat, often followed by a stronger-than-usual beat. The pause is actually the heart waiting for the regular rhythm to resume. Following the pause, the normal contraction is often stronger than usual due to the presence of a greater volume of blood in the chambers.
Premature contractions may occur for a number of reasons, including an imbalance of electrolytes in the body, certain medications, alcohol or drug use, or increased adrenaline, for instance from exercise or anxiety or the consumption of caffeine or tobacco. Rarely, premature contractions are an indication of an underlying heart condition, such as congenital heart disease, heart failure or scarring of the heart muscle.
In most cases, premature contractions do not require treatment. However, if the symptoms are bothersome or the contractions may exacerbate underlying heart conditions, premature contractions may be treated with medications such as beta-blockers, calcium channel blockers or antiarrhythmics. Your doctor may also instruct you to avoid things that can trigger the contractions, such as caffeine, alcohol or stressful situations.
If lifestyle changes and medications are not effective in reducing or eliminating the premature contractions, your doctor may use cardiac ablation to treat them instead. During an ablation procedure, one or more thin, flexible tubes are guided with X-rays into blood vessels and directed to the heart muscle. Then radiofrequency energy is delivered to destroy very tiny areas of tissue that give rise to abnormal electrical signals.
Emory Healthcare recently launched new screening centers across the Atlanta area to help diagnosis abnormal heart rhythms. If you experience symptoms of premature contractions or any other abnormal heart rhythm, you can visit one of our new screening locations to determine if your condition is serious. In addition to screenings, the new clinics offer state-of-the-art care by some of the country’s leading arrhythmia experts. Clinics in Villa Rica, Conyers and Johns Creek are already operating, and a fourth location in Decatur will open later this summer.
About Dr. Merchant
Faisal Merchant, MD , is an assistant professor of medicine who practices primarily at Emory University Hospital Midtown. He received his medical degree from Duke University, completed internal medicine and general cardiology training at Massachusetts General Hospital in Boston and a cardiac electrophysiology fellowship at Emory. He specializes in cardiac electrophysiology and treats all forms of arrhythmias, including pacemaker and defibrillator implantation and catheter ablation.
About Emory’s Arrhythmia Center
Emory’s Arrhythmia Center is one of the most comprehensive and innovative clinics for heart rhythm disorders in the country. Our electrophysiologists have been pioneers in shaping treatment options for patients with arrhythmias such as atrial fibrillation, as well as for those with congestive heart disease. Our specialized electrophysiology (EP) labs host state-of-the-art equipment, including computerized three-dimensional mapping systems to assist with the ablation of complex arrhythmias, and an excimer laser system to perform pacemaker and defibrillator lead extractions.
Patients with devices, whether implanted at Emory or elsewhere, have access to Emory’s comprehensive follow-up care. Patients benefit from remote monitoring, quarterly atrial fibrillation support groups and 24-hour implantable cardiac device (ICD) and pacemaker monitoring services. Inpatient telemetry and coronary care units, as well as outpatient care and educational support of patients with pacemakers and ICDs, complete Emory’s comprehensive range of arrhythmia treatments and services.