Holter monitor shows supraventricular ectopics and PAC. Do I need antiarrhythmic drug?

Hello,

Welcome to icliniq.com.

Premature atrial contractions or supraventricular ectopics are not harmful per se other than giving you symptoms. So antiarrhythmics are not usually recommended, so I do not disagree with your treating cardiologist. Beta blocker is the safest option available, although not the most effective one and other options are ablation or antiarrhrythmics.

So trying behavioral techniques is a good option. But if it troubles you a lot then you may request low dose antiarrhythmics like Amiodarone for a short period of time, but they may again come back after the drug is stopped. Since there is no atrial fibrillation or SVT (supraventricular tachycardia), antiarrhythmics are absolutely necessary, but the benefit would be in you is just symptomatic, which comes with the risk of side effects.

However, you should have Holter at regular intervals like yearly (with echo for aortic regurgitation), or if you notice sustained ectopics or irregular rhythm implying development of fibrillation. You may discuss changing Atenolol to others like Metoprolol and see if its help. You should try to identify triggers like sleep or gastric disturbances, alcohol or smoking (if any), any particular medications (which you are on), stress, etc. Also, if not had recently, thyroid should be tested.

So in a nutshell, antiarrhythmics may be avoided, but if not tolerable symptomatically then may be tried.

I hope this helps.

Hello,

Welcome back to icliniq.com.

No, they will not kill you. The only risk is of progression of PAC (premature atrial complex) to atrial fibrillation, which would remain. And rarely, PAC may temporarily reduce heart function (ejection fraction). So these are risks, which anyway would be monitored in you with yearly or 2 yearly echos and Holter.

You may have your own ECG (electrocardiography) watch to see the rhythm intermittently. Just monitor for symptoms like sudden palpitations, associated with shortness of breath, dizziness, or chest pain, which may indicate atrial fibrillation, after which you may need blood thinners as well. So nothing to worry about it as of now and it will not kill you.