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Atrial and Ventricular Premature Beats - Symptoms and TreatmentAn atrial premature beat (atrial ectopic beat, premature atrial contraction) is an extra heartbeat caused by electrical activation of the atria from an abnormal site before a normal heartbeat would occur. The contour of the P wave usually differs from the patient's normal complex. The subsequent RR cycle length is usually unchanged or only slightly prolonged. Such premature beats occur frequently in normal hearts and are never a sufficient basis for a diagnosis of heart disease. Speeding of the heart rate by any means usually abolishes most premature beats. Early atrial premature beats may cause aberrant QRS complexes (wide and bizarre) or may be nonconducted to the ventricles because the latter are still refractory. Atrial premature beats occur in many healthy people and rarely cause symptoms. Atrial premature beats are common among people who have lung disorders and are more common among older people than among younger people. These beats may be caused or worsened by consuming coffee, tea, or alcohol and by using some cold, hay fever, and asthma remedies. Atrial and ventricular premature beats. Ventricular premature beat does not reach sinus node; hence, there is full compensatory pause (enclosed area is equal to two sinus cycles). Panel B: Three premature atrial beats. First beat blocks, second and third conduct aberrantly. Panel C: A junctional premature beat (no prior P wave). Next sinus beat is on time and conducts with longer PR interval (interpolated junctional premature beat). Lead II or V1 was used and is indicated in this and all subsequent rhythm traces.
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