Heart Skipping? Why Your Heart Has APCs & Medical Next Steps

If you've ever felt your heart "skip," flutter, or briefly pound in your chest, you're not alone. One common reason for this sensation is something called an APC — short for atrial premature contraction (also known as a premature atrial contraction or PAC).

In many cases, an APC is harmless. But sometimes it can signal an underlying issue that deserves attention. Understanding what an APC is, why it happens, and when to seek medical care can help you stay informed without unnecessary worry.

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What Is an APC?

An APC (atrial premature contraction) is an early heartbeat that starts in the upper chambers of your heart (the atria).

Normally, your heartbeat follows a steady electrical pattern controlled by the sinus node — your heart's natural pacemaker. With an APC:

• An extra electrical signal fires early.
• The heart beats sooner than expected.
• This is often followed by a brief pause.
• You may feel a "skip," "flip," or "thump."

That "skipping" feeling is usually the pause after the early beat — not your heart stopping.

APCs are extremely common. In fact, most people have them at some point, even if they never notice.

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What Causes APCs?

APCs can happen in healthy hearts. They don't always mean something is wrong. Common triggers include:

Everyday Triggers

• Stress or anxiety
• Caffeine (coffee, energy drinks, soda)
• Alcohol
• Nicotine
• Lack of sleep
• Dehydration
• Intense exercise

Medical Factors

• High blood pressure
• Heart disease
• Electrolyte imbalances (low potassium or magnesium)
• Thyroid disorders (especially hyperthyroidism)
• Lung disease
• Infection or fever

Sometimes, no clear cause is found.

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Are APCs Dangerous?

In most healthy people, occasional APCs are benign (not dangerous).

However, the context matters.

Generally Reassuring Signs:

• Infrequent episodes
• No other symptoms
• Normal heart structure
• Normal ECG apart from APCs

Situations That Deserve Medical Attention:

• Very frequent APCs
• Associated chest pain
• Shortness of breath
• Dizziness or fainting
• Known heart disease
• Family history of sudden cardiac death

Frequent APCs can sometimes increase the risk of developing atrial fibrillation (AFib), a more serious irregular heart rhythm. This does not mean APCs automatically lead to AFib — but persistent or increasing episodes should be evaluated.

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What Do APCs Feel Like?

People describe APC sensations differently:

• A flutter in the chest
• A skipped beat
• A brief pounding
• A flip-flop sensation
• A pause followed by a strong beat

Some people feel them mostly at night when lying down. Others notice them during stress.

Many people have APCs but never feel them at all.

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How Are APCs Diagnosed?

If you report palpitations, a doctor may recommend:

1. Electrocardiogram (ECG or EKG)

A quick test that records your heart's electrical activity.

2. Holter Monitor

A portable device worn for 24–48 hours to capture irregular beats during daily activity.

3. Event Monitor

Worn longer (weeks) to catch less frequent symptoms.

4. Blood Tests

To check:

• Thyroid levels
• Electrolytes
• Signs of infection

5. Echocardiogram

An ultrasound of the heart to evaluate structure and function.

If your heart structure is normal and APCs are isolated, your doctor may simply monitor the situation.

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How Are APCs Treated?

Treatment depends on frequency, symptoms, and underlying cause.

If APCs Are Infrequent and Mild:

Often, no treatment is needed.

Your doctor may recommend lifestyle changes:

• Reduce caffeine
• Limit alcohol
• Improve sleep
• Manage stress
• Stay hydrated
• Quit smoking

If Symptoms Are Frequent or Bothersome:

Medications may be considered, such as:

• Beta blockers (to reduce heart irritability)
• Calcium channel blockers

If There's an Underlying Condition:

Treatment focuses on the root cause:

• Correct thyroid imbalance
• Adjust electrolytes
• Treat high blood pressure
• Manage heart disease

In rare cases of very frequent APCs causing complications, more advanced treatment (such as catheter ablation) may be considered.

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When Should You Seek Immediate Care?

Call emergency services or seek urgent care if palpitations are accompanied by:

• Chest pain or pressure
• Fainting or near fainting
• Severe shortness of breath
• Sudden weakness or numbness
• Confusion
• Sustained rapid heart rate

These symptoms could indicate something more serious than an isolated APC.

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How Common Are APCs?

Very common.

Studies using continuous heart monitoring show that:

• Most adults have occasional APCs.
• Frequency increases with age.
• Many people are unaware they have them.

In older adults, frequent APCs are more common and may warrant closer monitoring.

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Can Stress Cause APCs?

Yes.

Stress activates the sympathetic nervous system (the "fight or flight" response), which can:

• Increase adrenaline
• Increase heart rate
• Trigger premature beats

Chronic stress can make APCs more noticeable. Stress management techniques such as deep breathing, meditation, regular exercise, and therapy may reduce episodes.

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APCs vs. Other Arrhythmias

It's important not to assume every skipped beat is harmless.

Other rhythm problems that may cause palpitations include:

• Atrial fibrillation
• Atrial flutter
• Supraventricular tachycardia (SVT)
• Ventricular premature contractions (VPCs or PVCs)

Only proper medical evaluation can distinguish these.

If you're experiencing heart palpitations or irregular beats and want to better understand whether your symptoms align with common patterns, you can use a free AI-powered Benign Arrhythmias (Palpitations) symptom checker to help determine your next steps before seeing a doctor.

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Can APCs Be Prevented?

You may not be able to prevent all APCs, but you can reduce triggers.

Helpful habits include:

• Maintain healthy blood pressure
• Exercise regularly (moderate intensity)
• Avoid excessive stimulants
• Eat a balanced diet rich in potassium and magnesium
• Manage anxiety
• Get consistent sleep

If you notice patterns — for example, APCs after coffee — adjusting that habit may help.

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The Bottom Line

An APC (atrial premature contraction) is an early heartbeat originating in the upper chambers of the heart. It often feels like a skipped beat or flutter.

For most healthy people:

• APCs are common.
• APCs are benign.
• APCs do not require treatment.

However, frequent or symptomatic APCs can sometimes signal an increased risk of other rhythm problems and should be evaluated.

Do not ignore:

• Chest pain
• Fainting
• Severe shortness of breath
• Persistent rapid heart rate

If you are experiencing concerning symptoms, speak to a doctor promptly. If something feels severe or life-threatening, seek emergency medical care immediately.

Even if your symptoms seem mild, it's wise to speak to a doctor to confirm that your heart rhythm is safe and to rule out serious causes.

Most importantly: feeling a skipped beat can be unsettling, but in many cases, APCs are manageable and not dangerous — especially when properly evaluated.

Taking informed, calm next steps is the best way to protect your heart health.