Supraventricular Premature Beats

How to Cite This Chapter: Acosta Velez JG, Amit G, Hernández Ruiz EA, Trusz-Gluza M, Leśniak W. Supraventricular Premature Beats. McMaster Textbook of Internal Medicine. Kraków: Medycyna Praktyczna. Accessed July 07, 2020.
Last Updated: December 10, 2018
Last Reviewed: August 5, 2019
Chapter 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 (see Table 3.4-1).

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