Premature Atrial Contraction (Multiple) Vs. Premature Atrial Contraction (Couplet) on Your Watch ECG

PAC Couplet ECG
Qaly Heart
Qaly is built by Stanford engineers and cardiologists, including Dr. Marco Perez, a Stanford Associate Professor of Medicine, Stanford Cardiac Electrophysiologist, and Co-PI of the Apple Heart Study.

Key Takeaways

Got other questions on PAC? See the Qaly guides on PAC:

Introduction

The language of the heart is communicated through the rhythm it beats, a language that medical professionals decode through an electrocardiogram (ECG). But you don't always need to be in a clinic to understand your heart. ECG watches have made it possible for anyone to monitor their heart rhythms. In this discussion, we will delve into two types of heart rhythms: premature atrial contraction (multiple) and premature atrial contraction (couplet), frequently mentioned as "PAC vs atrial couplet". Let’s dive in.

What’s a Premature Atrial Contraction (PAC)?

Premature atrial contractions are early beats that originate from the atria — the upper chambers of the heart. When multiple PACs occur, they appear as irregular early beats on an ECG. While occasional PACs are usually benign, frequent PACs can sometimes indicate underlying heart disease or trigger other arrhythmias. 

PACs read on a Kardia ECG through the Qaly app.
PACs read on a Kardia ECG through the Qaly app.

On an ECG, PACs are identified by an early and often different-looking P wave, followed by a QRS complex and a compensatory pause. Here’s more on what multiple PACs look like on your watch ECG.

PACs read on a Fitbit ECG through the Qaly app.
PACs read on a Fitbit ECG through the Qaly app.

What’s a PAC Couplet?

When PACs occur in pairs, they are referred to as a couplet. While occasional PACs are usually benign, frequent PACs can sometimes indicate underlying heart disease or trigger other arrhythmias. Here’s more on what a PAC couplet looks like on your watch ECG.

PAC Couplet read on a Fitbit ECG through the Qaly app.
PAC Couplet read on a Fitbit ECG through the Qaly app.


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PAC Couplet read on a Fitbit ECG through the Qaly app.
PAC Couplet read on a Fitbit ECG through the Qaly app.

What’s the Difference Between Multiple PACs and a PAC Couplet?

When comparing multiple PACs with a couplet PAC, the key distinction is in the number and arrangement of premature beats. While multiple PACs can occur randomly throughout the rhythm, a couplet PAC specifically refers to two consecutive PACs.

Both multiple PACs and couplet PACs may be asymptomatic or cause feelings of fluttering, palpitations, or a sense of a skipped beat. They could be random or triggered by factors such as stress, caffeine, alcohol, or certain medications. The health implications of PAC vs atrial couplet primarily depend on their frequency and the presence of underlying heart conditions.

While a watch ECG can help identify and monitor these rhythms, it is crucial to consult a healthcare provider for a comprehensive evaluation if such patterns are observed. Remember, personal ECG devices are meant for informational purposes and are not a replacement for professional medical advice. Stay informed, stay proactive, and stay heart healthy!

Still Not Sure if It’s Premature Atrial Contraction (Multiple) or Premature Atrial Contraction (Couplet) on Your ECG?

Differentiating between multiple PACs vs a PAC couplet on your ECG can be tricky. If you’re still looking for help interpreting your ECG further, check out the Qaly app on App Store or Play Store. On Qaly, human experts will interpret your ECGs within minutes, day or night. Try out the Qaly app for free today!

Wondering if it's PACs or PAC Couplet? On the Qaly app, human experts will interpret your ECGs for PACs and PAC Couplet within minutes. Get started for free today.

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Try Qaly for Free
App Store - Download Qaly | ECG Reader
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Google Play - Download Qaly | ECG Reader
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QALY app - ecg reviews, ecg reader, ecg interpretations, review your ecg

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Wondering if it's PACs or PAC Couplet? On the Qaly app, human experts will interpret your ECGs for PACs and PAC Couplet within minutes. Get started for free today.

Try Qaly for Free