Table of ContentsView AllTable of ContentsSymptomsWhen to Seek CareComplicationsPreventionCausesDiagnosisManagement
Table of ContentsView All
View All
Table of Contents
Symptoms
When to Seek Care
Complications
Prevention
Causes
Diagnosis
Management
Apremature ventricular complex(PVC, or premature ventricular contraction) is an extra electrical impulse arising from one of theheart’s ventricles. This extra impulse happens before the next normal heartbeat has a chance to occur.
PVCs are very common and usually harmless. Most do not cause symptoms and resolve on their own without treatment. If you are experiencing symptoms, such as dizziness or fainting, tell your healthcare provider. In many cases, simply lifestyle changes like limiting caffeine are enough to manage symptoms.
This article provides an overview of the symptoms, causes, and diagnosis of PVCs. You’ll also learn about when treatment for PVCs may be indicated, and what those therapy options entail.
What Are the Symptoms of PVCs?
Many people with PVCs do not feel them at all. Others describe them as a “fluttering” or “flip-flopping” feeling in the chest.
In some people, these unusual heartbeat sensations can be difficult to tolerate.
Other PVC symptoms may include:
Risk Factors
The risk of PVCs is higher in people with certain health conditions, such as:
Certain lifestyle factors also increase the risk of PVCs, including:
People with obesity are also at an increased risk of PVCs.
When to See a Healthcare Provider
For most people, PVCs are harmless and do not cause symptoms. If the PVCs happen occasionally or do not come with other symptoms, then you do not need to see a healthcare provider.
If you have PVCs that are becoming more frequent, plan to see a healthcare provider for an evaluation.
See a healthcare provider right away if you have PVCs in addition to:
These can be signs of a more serious heart problem.
What Are the Potential Complications of PVCs?
PVCs usually are not dangerous in healthy people. However, in people with heart problems or a history of heart attack, PVCs can trigger more dangerous heart rhythm abnormalities, such as:
Although it is rare for PVCs to trigger these types of serious heart rhythm abnormalities, they should not be ignored. Both VT and VF can be life-threatening if they are not treated promptly. In severe cases, they can result insudden cardiac arrestand death.
High-frequency PVCs occur when 20% to 40% of heartbeats in 24 hours are PVCs. High-frequency PVCs can also be dangerous, as they can weaken the heart muscle over time. Eventually, this can lead to a heart disease calledcardiomyopathy, in which the heart loses its ability to pump blood effectively.
If you think you might be having an abnormally fast or irregular heartbeat, see your healthcare provider for an evaluation.
How Are PVCs Prevented?
You may not be able to stop PVCs entirely, but you can take steps to help prevent them:
Whether you have PVCs or not, it’s important to stay on top of any medications or treatments that are prescribed to you.
What Are the Causes of PVCs?
But more frequently, they occur in people with underlying heart disease. Heart conditions associated with PVCs include:
People with chronic high blood pressure (hypertension) may also develop structural changes in their hearts that lead to PVCs. Additionally, an injury to the heart can make the cells of the ventricles electrically unstable and cause PVCs.
There are also other health factors or problems not necessarily related to the heart that may contribute to the development of PVCs.
These include:
How Are PVCs Diagnosed?
With this test, flat disks that can detect electrical activity of the heart are placed on your chest. Results are graphed on a monitor.
In some cases, PVCs are diagnosed incidentally through a routine ECG—for example, during a preoperative evaluation before surgery.
When symptoms are present, PVCs are diagnosed through an ECG or a more sophisticated tool called anambulatory ECG monitoring system.
Ambulatory ECG monitoring systems are portable devices that are worn for a long period of time to capture and record abnormal heart rhythms (arrhythmias) that may come and go.
AHolter monitoris one type of ambulatory ECG system that may be used to diagnose and measure the frequency of PVCs.It records the electrical activity of your heart continuously for 24 to 48 hours.
Additional Testing
To help determine if your PVCs are benign, your healthcare provider will want to assess several things from the history and physical exam, laboratory evaluation, and cardiac imaging tests.
Depending on findings from your medical history/physical exam, various blood tests may be ordered.
For example, if an electrolyte imbalance is suspected, abasic metabolic paneland a magnesium level may be ordered. Likewise, if you are taking Digox (digoxin) for heart failure or another arrhythmia, a digoxin level will probably be ordered.
Further testing to look for previously unknownheart diseaseis also commonly performed.
In general, anechocardiogram, which is an ultrasound of your heart, is the main way to screen for most underlying heart conditions. In select cases, your doctor may want to perform a nuclear stress test or acardiac magnetic resonance imaging (MRI).
Besides revealing an image of the heart’s anatomy, an echocardiogram provides a measurement called theleft ventricular ejection fraction, or LVEF.An LVEF reveals how well your heart is pumping blood. A reduced LVEF indicates that your heart muscle not working as well as it should. Knowing your LVEF is important, as it can affect how (or if) your doctor decides to treat your PVCs.
Around 50% of people with or without heart disease will have at least one PVC during a 24-hourHolter monitor study.
Verywell / Cindy Chung
Management of PVCs
Managing PVCs is not a straightforward matter, as their impact can vary from person to person.
Once it’s understood exactly what is going on with the heart—and that it is common and not dangerous—you may be less likely to become anxious when PVCs occur.
PVCs can create a vicious cycle, because the anxiety they provoke can cause an increase in neurohormonal factors (catecholamines/adrenalin). These factors may increase heart rate and make the heart beat stronger, which can increase the frequency of the PVCs.
Regular follow-up with a primary care physician is recommended for patients with infrequent PVCs, no symptoms, and a normal LVEF.
For those with frequent PVCs but no symptoms and a normal LVEF, yearly echocardiograms and follow-up with a cardiologist are advised.
Beyond that, the following may be considered:
Potassium
Radiofrequency Ablation
Painless radiofrequency energy is used to destroy heart tissue deemed to be the source of abnormal electrical signals.
Ablation may be warranted in certain highly symptomatic people. It may also be considered in those with a low LVEF who have frequent PVCs, regardless of whether symptoms are present or not.
Ablation carries significant risks of major cardiac events, which occur in 3%-5% of cases.
Summary
PVCs are abnormal heartbeats that begin in one of your heart’s lower chambers. They are common and may causepalpitations, lightheadedness, or no symptoms at all. Once PVCs are diagnosed, an echocardiogram is typically performed to assess the heart’s function and structure.
Thetreatment of PVCsis highly variable, ranging from annual checks to taking medications or undergoing an ablation procedure. Although frequent PVCs can increase the risk of other abnormal heart rhythms, the vast majority of people who have PVCs will continue to live a long life.
14 Sources
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