Atrial fibrillation (AFib) and premature ventricular contraction (PVC) are both common heart rhythm problems. Both conditions can cause symptoms such as palpitations, pounding heartbeat, chest pain, and dizziness.

The heart has an electrical conduction system, which ensures that it contracts in a coordinated rhythm to help pump blood throughout the body. Any problem with the electrical signals can lead to irregular heart rhythms, or arrhythmias. The problem may begin in the upper chambers (atria), in the lower chambers (ventricles), or anywhere in the conduction system.

There are many types of arrhythmias. AFib and PVC are two common types.

In this article, we will explore AFib and PVC, including the link between the conditions, their complications, and treatment options.

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The definitions of these two heart rhythm problems are as follows:

AFib

AFib is the most common type of arrhythmia, affecting roughly 1% of the world’s population. Research estimates that AFib affects 3–6 million people in the United States and that this may increase to roughly 6–16 million by 2050.

The condition occurs as a result of abnormal electrical activity within the atria that causes them to quiver, or fibrillate. This prevents the heart’s chambers from working together, disrupting blood flow from the atria to the ventricles.

As a result, the ventricles may not fill completely, and blood may pool in the atria. This can lead to blood clots, which can travel to the brain and cause a stroke.

The condition can cause fast and irregular heartbeats since the electrical signals from the atria to the ventricles are erratic.

Some people with AF do not experience symptoms, while others experience one or more of the following:

  • rapid, irregular heartbeats
  • fluttering or pounding in the chest
  • shortness of breath
  • anxiety
  • faintness or dizziness
  • confusion
  • fatigue when exercising
  • general fatigue
  • sweating
  • chest pain or pressure

PVC

Some healthcare professionals may refer to PVC as premature ventricular complexes or an ectopic heartbeat. This term describes an extra heartbeat that occurs just before a regular heartbeat or between regular heartbeats. PVCs specifically are extra heartbeats that originate in the ventricles.

Instead of beginning in the sinoatrial node, which usually starts the heartbeat, a PVC begins from the Purkinje fibers. PVCs can also begin in scar tissue or anywhere in the myocardium — the muscle tissue of the heart.

Because a PVC occurs earlier than a regular heartbeat, there is a pause before the next regular heartbeat.

PVCs are relatively common, with evidence suggesting a prevalence of 1–4% within the general population. The most common sensation a person with PVC reports is a skipped beat followed by a fluttering or “flip-flop” sensation in the chest.

Many people do not experience PVC symptoms. However, those who do may experience:

AFib and PVC have some similar symptoms:

  • palpitations
  • fatigue
  • shortness of breath
  • chest pain
  • lightheadedness
  • anxiety

The two conditions also have some of the same causes, including:

Learn more about different types of sleep apnea here.

Several studies have found associations between the two conditions.

PVCs have an association with a 1.90-fold increased incidence of AFib. A 2021 study also found that having PVC increases a person’s risk of new-onset AFib and ischemic stroke. And, in a 2020 case study, researchers reported that PVCs may trigger AFib episodes.

An elevated PVC count on a Holter monitor or ambulatory arrhythmia monitor also predicts incident AFib and heart failure. Similarly, PVC and premature atrial contraction (PAC) on 12-lead ECG have an association with an increased risk of AFib, heart failure, and death.

These two conditions are usually not severe or life threatening in otherwise healthy individuals.

AFib is not fatal in itself, but it can lead to serious complications. It is associated with a high risk of blood clot formation and potential complications. People with AFib have a three- to fivefold increased risk of experiencing a stroke. Untreated and persistent AFib can eventually weaken the heart, causing heart failure.

Individuals who have PVC without structural heart disease and who have only infrequent PVCs usually lead typical lives, like the general population. However, those with at least 10,000 PVCs per day or greater than 10% PVC burden are at risk of dilated cardiomyopathy, a disease that affects the heart muscle.

Increased PVC frequency can also put a person at risk of heart failure and death. PVCs can weaken the heart muscle and cause cardiomyopathy, but the opposite is also true: Sometimes frequent PVCs can be a marker of underlying cardiomyopathy.

Some people with rare PVCs do not usually need treatment unless they have an underlying heart disease. If a person has PVCs, a doctor will order an echocardiogram and may order a cardiac MRI to determine whether the person has any structural heart disease. On the other hand, individuals with AFib often need treatment to help reduce the risk of complications.

Initially, a healthcare professional may run some tests to determine the underlying cause of the arrhythmia and guide the treatment options. They may recommend lifestyle strategies and medications to treat the two conditions. They may advise undergoing a surgical procedure if these approaches do not help manage the symptoms.

Lifestyle strategies

To help manage PVC, a doctor may recommend limiting consumption of stimulants such as caffeine and nicotine. They may also recommend replenishing a person’s electrolytes, such as magnesium and potassium.

For people with AFib, the following lifestyle strategies can help manage the condition:

  • quitting smoking
  • managing hypertension
  • limiting or stopping alcohol consumption
  • limiting stimulants such as caffeine
  • getting enough sleep
  • managing and treating diabetes, if necessary
  • eating a nutritious diet
  • making efforts to maintain a moderate weight
  • finding healthy ways to manage stress
  • getting enough physical activity

Medications

The medications doctors prescribe for AFib and PVC help regulate the heart rate and heart rhythm.

Heart rate-controlling drugs, or anti-arrhythmic drugs, help regulate the heart rate. They typically do so by slowing the heart rate. Beta blockers and calcium channel blockers are examples of these medications.

Heart rhythm-controlling drugs attempt to restore the heart rhythm to normal. These drugs allow the heart to reset into a typical rhythm. Sodium channel blockers and potassium channel blockers are examples.

Learn more about medications for AFib here.

Surgical procedures

Individuals who have symptomatic PVC or experience several thousand PVCs each day may be candidates for radiofrequency catheter ablation. This is a procedure that destroys the cells causing the arrhythmia.

A doctor may also recommend procedures to people with AFib if their condition does not respond to medications and lifestyle strategies. These procedures may include:

AFib and PVC are common types of arrhythmia, or irregular heartbeat, that may affect the general population. Because both occur as a result of problems with the heart’s electrical conduction system, they have some similar symptoms, causes, and treatments. These conditions are typically not fatal but may lead to severe complications.

Several studies show associations between the two conditions and suggest that having PVC may increase a person’s risk of developing AFib. Typically, a doctor will recommend lifestyle strategies and medications to help a person manage these conditions and prevent complications.