### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am experiencing PACs.  A few years ago I started having them, then the went away, then came back for a few days once each month.  About 2 months ago I started Zoloft, a month after that I started having PACs morning and night and occasionally throughout the day.  Is the Zoloft the cause of the increased PACs?

### output:

Hello and thank you for using Chat Doctor. I carefully read your question and I totally understand your concern. But you should not worry. These premature beats have to do with some electrical issues in the heart. Some electrical impulses that generate in a part of the heart different from normal sinus rhythm cause a premature heart contraction that you feel like a skipped beat, because it's not a normal one. This extra-sistolik beats generally are followed by a pause till the next normal heart contraction. If these are not frequent, in Young and normal heart, it is nothing to worry about. There are different factors that might cause this skipped beats like emotional stress, excessive coffee consumption, coca-cola or energy Chat Doctor. As you explain you have experienced this premature beats even before taking Zoloft. So my opinion is that Zoloft is not the cause of your palpitations. In general, it helps to treat anxiety problems that do cause extra-systolic beats. Only in a small category of people Zoloft might have a side effect to increase heart beats, but it is not your case, as it has happened before. Pathology like anemia or hyperthyroidism might be other causes of premature contractions. So, if I was your treating doctor I would say that you have nothing to worry if this happens once a wile, its normal. But if they begin to bother you and interfere in your live we can decide to do some examinations like a blood analyze, your thyroid hormones, an electrocardiogram, echocardiography and of course a holder rhythm monitoring to have a full view of your rhythm and the extra-sistolik beat frequencies. Onliest than we can decide what we should do and if it is necessary to stop Zoloft. Hope I was helpful. Best regards.