[Premature complexes, anxiety and quality of life]

Premature complexes can be indicative of an increased cardiac risk or can contribute to the initiation or deterioration of heart failure in particular in the presence of organic heart disease. Most premature complexes are benign. The postextrasystolic pause or the augmented postextrasystolic premature beat may cause the following symptoms: feeling of a skipped beat or the sensation of a pounding heart beat causing the feeling "that something is seriously wrong". It is mentioned that premature beats cause an unconscious reaction of the autonomic nervous system. Symptoms related to premature complexes may cause uneasiness or franc anxiety which may itself intensify the symptoms. This may cause a panic reaction which may be associated with shortness of breath or angina of the chest mimicking dyspnea of heart failure of an acute coronary syndrome. Along the "vicious cycle of anxiety" it is demonstrated how patients may be comforted. In addition, the panic disorder itself should be treated by cognitive behavioral or psychodynamic therapy.