Supraventricular Premature Beats

Chapter: Supraventricular Premature Beats
McMaster Section Editor(s): P.J. Devereaux
Section Editor(s) in Interna Szczeklika: Andrzej Budaj, Wiktoria Leśniak
McMaster Author(s): Juan Gabriel Acosta Velez, Guy Amit, Eder Augusto Hernández Ruiz
Author(s) in Interna Szczeklika: Maria Trusz-Gluza, Wiktoria Leśniak
Additional Information

Definition, Etiology, PathogenesisTop

Supraventricular premature beats (SPBs) originate outside the sinus node, in the atrium and in the veins draining to the atria. They are classified as premature or escape beats. SPBs are most frequently single but may be also multiple and have the form of nonsustained supraventricular tachycardia (usually atrial tachycardia). They are common in healthy individuals.

SPBs are frequently transitory and associated with a transient triggering factor, such as emotions, stimulants (alcohol, caffeine, drugs of abuse), electrolyte disturbances, infection, or thyrotoxicosis.

Clinical Features and Natural HistoryTop

SPBs are usually asymptomatic, although sometimes patients may experience irregular heartbeats or pauses. Nonconducted SPBs can lead to effective bradycardia, as some do not produce an effective stroke volume. Multiple SPBs may affect the quality of life and increase the risk of atrial fibrillation.


1. Treatment is rarely necessary. However, the triggering factors should be eliminated.

2. In patients with severe symptoms, multiple SPBs, or short episodes of atrial fibrillation, consider a beta–blocker or calcium channel blocker (verapamil or diltiazem), or rarely a class I antiarrhythmic agent (Table 3.4-1).

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