What are the differences between cardiac premature beats and atrial fibrillation?

Mar 03, 2025 Source: Cainiu Health

Dr. Tian Hongbo

Introduction

In general, cardiac premature beats refer to premature contractions, while atrial fibrillation refers to atrial flutter. The differences between premature contractions and atrial fibrillation include distinct causes, different origins, varying arrhythmia characteristics, differing electrocardiogram (ECG) manifestations, and varied symptoms. If you experience any discomfort, it is recommended to seek medical attention promptly. In daily life, maintaining a regular routine and engaging in appropriate physical exercise can help improve cardiac function.

Generally speaking, cardiac premature beats refer to premature contractions, while atrial fibrillation refers to atrial flutter. Differences between premature contractions and atrial fibrillation include distinct causes, different origins, varying cardiac rhythm characteristics, differing electrocardiogram (ECG) manifestations, and varied symptoms. If discomfort occurs, timely medical consultation is recommended. Detailed analysis is as follows:

1. Different Causes

Premature contractions can be caused by various factors such as emotional excitement, excessive fatigue, smoking, alcohol consumption, or drinking strong tea or coffee. They may also occur in various types of organic heart disease. Atrial fibrillation commonly occurs in patients with rheumatic heart disease, hypertension-induced heart disease, cardiomyopathy, and congenital heart disease. It can also be triggered by hyperthyroidism or chronic obstructive pulmonary disease (COPD).

2. Different Origins

Premature contractions originate from ectopic pacemaker sites in the atrium, atrioventricular junction, or ventricle. In contrast, atrial fibrillation results from multiple ectopic excitation foci within the atria firing impulses simultaneously, leading to the loss of normal atrial rhythm.

3. Different Cardiac Rhythm Characteristics

Premature contractions manifest as early heartbeats followed typically by a complete or incomplete compensatory pause. Atrial fibrillation, however, presents with rapid and irregular atrial excitation, resulting in absolutely irregular ventricular rates.

4. Different ECG Manifestations

On ECG, premature contractions show early P waves, retrograde P waves, or widened and bizarre QRS complexes, which differ in morphology from normal sinus rhythm. In atrial fibrillation, the ECG lacks normal P waves and instead displays fibrillatory waves (f waves) of varying sizes and shapes, with absolutely unequal RR intervals.

5. Different Symptoms

Patients with premature contractions often experience palpitations and sometimes feel a pause in heartbeat or a sense of heart racing; some patients may not exhibit obvious symptoms. Patients with atrial fibrillation frequently experience palpitations, dizziness, chest tightness, and fatigue. Severe cases may lead to syncope, heart failure, or shock.

In daily life, maintaining a regular lifestyle and engaging in appropriate physical exercise can help improve cardiac function.

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