From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Treatment for Premature Atrial Contractions (PACs) should prioritize beta-blockers as the first-line medication, as they have been shown to decrease long-term mortality in high-burden and low-burden patients, according to the most recent study 1. When considering treatment options for PACs, it's essential to evaluate the symptom severity and frequency of the contractions. For most people with occasional PACs that cause minimal symptoms, no treatment is necessary beyond avoiding triggers like caffeine, alcohol, tobacco, and stress.
- Lifestyle changes, including regular exercise, adequate sleep, and reducing stimulant intake, often provide sufficient relief.
- For patients with more frequent or symptomatic PACs, medications may be prescribed, including beta-blockers (such as metoprolol 25-100 mg twice daily or atenolol 25-100 mg daily) or calcium channel blockers (like diltiazem 120-360 mg daily or verapamil 120-360 mg daily).
- These medications work by slowing electrical conduction through the heart and reducing the excitability of cardiac tissue.
- For severe cases where PACs trigger more dangerous arrhythmias or significantly impact quality of life despite medication, catheter ablation may be considered, as mentioned in a recent study 2. The choice of treatment should be individualized based on symptom burden, frequency of PACs, underlying heart conditions, and patient preferences, with regular follow-up to assess effectiveness and adjust therapy as needed.
- A study comparing beta-blockers and calcium channel blockers in patients with atrial fibrillation found that beta-blockers were more potent for rapid reduction of the heart rate and demonstrated better efficiency in shortening the duration of hospitalization in a subgroup of patients 3.
- Another study highlighted the importance of considering the role of non-dihydropyridine calcium channel blockers and beta-blockers in atrial fibrillation and acute decompensated heart failure, emphasizing the need for further research to assess their safety and efficacy in both acute and chronic settings 4.
- However, the most recent and highest-quality study 1 supports the use of beta-blockers as the primary treatment for PACs, making them the preferred choice for managing this condition.