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Premature Ventricular Contractions
(PVCs)
Overview
Premature ventricular contractions (PVCs) are extra heartbeats that
begin in one of the heart's two lower pumping chambers (ventricles).
These extra beats disrupt the regular heart rhythm, sometimes causing a
sensation of a fluttering or a skipped beat in the chest.
Premature ventricular contractions are a common type of irregular
heartbeat (arrhythmia). premature ventricular contractions (PVCs) are
also called:
- Premature ventricular complexes
- Ventricular premature beats
- Ventricular extrasystoles
Occasional premature ventricular contractions in people without heart
disease usually aren't a concern and likely don't need treatment. You
might need treatment if the premature ventricular contractions are very
frequent or bothersome, or if you have an underlying heart condition.
Symptoms
Premature ventricular contractions often cause few or no
symptoms. But the extra beats can cause unusual
sensations in the chest, such as:
-
Fluttering
-
Pounding or jumping
-
Skipped beats or missed beats
-
Increased awareness of the heartbeat
When to see a doctor
If you feel fluttering, pounding or a sensation of
skipped heartbeats in your chest, talk to your health
care provider. A health care provider can determine if
the sensations are due to a heart condition or other
health concern. Similar signs and symptoms can be caused
by many other conditions such as anxiety, low red blood
cell count (anemia), overactive thyroid
(hyperthyroidism) and infections.
Causes
To understand the cause of premature ventricular contractions (PVCs),
it might help to learn more about how the heart typically beats.
The heart is made of four chambers — two upper chambers (atria)
and two lower chambers (ventricles).
The heart's rhythm is controlled by a natural pacemaker (the
sinus node) in the right upper chamber (atrium). The sinus node
sends electrical signals that typically start each heartbeat.
These electrical signals move across the atria, causing the
heart muscles to squeeze (contract) and pump blood into the
ventricles.
Next, the signals arrive at a cluster of cells called the
atrioventricular (AV) node, where they slow down. This slight
delay allows the ventricles to fill with blood. When the
electrical signals reach the ventricles, the chambers contract
and pump blood to the lungs or to the rest of the body.
In a typical heart, this heart signaling process usually goes
smoothly, resulting in a resting heart rate of 60 to 100 beats a
minute.
Typical heartbeat
In a typical heart rhythm, a tiny cluster of cells at the sinus
node sends out an electrical signal. The signal then travels
through the atria to the atrioventricular (AV) node and into the
ventricles, causing them to contract and pump blood.PVCs are irregular contractions that start in the ventricles
instead of the atria. The contractions usually beat sooner than the next
expected heartbeat.
The cause of premature ventricular contractions isn't always clear.
Certain things including heart diseases or changes in the body can make
cells in the lower heart chambers electrically unstable. Heart disease
or scarring may cause the heart's signals to be misrouted.
Premature ventricular contractions may be caused by:
- Certain medications, including decongestants and antihistamines
- Alcohol or drug misuse
- Stimulants such as caffeine or tobacco
- Increased levels of adrenaline in the body due to exercise or
anxiety
- Injury to the heart muscle due to disease
Risk factors
Certain lifestyle choices and health conditions may make a person
more likely to develop premature ventricular contractions (PVCs).
Risk factors for PVCs include:
- Caffeine
- Tobacco
- Alcohol
- Stimulants such as cocaine or methamphetamines
- Exercise — if you have certain types of PVCs
- Anxiety
- Heart attack
- Heart disease, including congenital heart disease, coronary
artery disease, heart failure and a weakened heart muscle (cardiomyopathy)
Complications
Having frequent premature ventricular contractions (PVCs)
or certain patterns of them might increase the risk of
developing irregular heart rhythms (arrhythmias) or
weakening of the heart muscle (cardiomyopathy).
Rarely, when accompanied by heart disease, frequent
premature contractions can lead to chaotic, dangerous
heart rhythms and possibly sudden cardiac death.
Diagnosis
To diagnose
premature
ventricular
contractions (PVCs),
a health care
provider will
typically listen
to your heart
with a
stethoscope. You
may be asked
questions about
your lifestyle
habits and
medical history.
Tests are done
to confirm a
diagnosis of
premature
ventricular
contractions.
Tests
An
electrocardiogram
(ECG or EKG) can
detect the extra
beats and
identify the
pattern and
source.
An
electrocardiogram
(ECG) is a quick
and painless
test to record
the heart's
electrical
activity. Sticky
patches
(electrodes) are
placed on the
chest and
sometimes the
arms and legs.
Wires connect
the electrodes
to a computer,
which displays
the test
results. An can
show if the
heart is beating
too fast, too
slow or not at
all.
If you don't
have premature
ventricular
contractions (PVCs)
very often, a
standard may not
detect them.
Your health care
provider may ask
you to use a
portable device
at home to
obtain more
information
about your
heartbeats.
Portable devices
include:
-
Holter
monitor. This
portable device
can be worn
for a day or
more to
record the
heart's
activity
during daily
activities.
Some
personal
devices,
such as
smartwatches,
offer
portable monitoring.
Ask your
health care
provider if
this is an
option for
you.
-
Event
monitor. This
portable device
is intended
to be worn
for up to 30
days or
until you
have an
irregular
heart rhythm
(arrhythmia)
or symptoms.
You usually
press a
button when
symptoms
occur. But
some
monitors
automatically
sense the
irregular
heartbeats
and then
start
recording.
Your health care
provider may
also recommend
an exercise
stress test.
This test often
involves walking
on a treadmill
or riding a
stationary bike
while an is
done. An
exercise stress
test can help
determine
whether exercise
triggers your PVCs.
Treatment
Most people with
premature
ventricular
contractions (PVCs)
who don't have
heart disease
won't need
treatment. If
you have heart
disease, PVCs can
lead to
more-serious
heart rhythm
problems
(arrhythmias).
Treatment
depends on the
underlying
cause.
A health care
provider may
recommend the
following
treatment for
frequent PVCs:
-
Lifestyle
changes. Eliminating
common
premature
ventricular
contraction
(PVC)
triggers —
such as
caffeine or
tobacco —
may reduce
the number
of extra
beats and
lessen
symptoms.
-
Medications. Blood
pressure
medications
may be
prescribed
to reduce
the
premature
contractions.
Those used
for PVCs may
include beta
blockers and
calcium
channel
blockers.
Drugs to
control the
heart rhythm
also may be
prescribed
if you have
a type of
irregular
heartbeat
called
ventricular
tachycardia
or frequent PVCs that
interfere
with heart
function.
-
Radiofrequency
catheter
ablation. If
lifestyle
changes and
medications
don't help
reduce the PVCs,
a catheter
procedure
may be done
to stop the
extra beats.
In this
procedure, a
health care
provider
threads one
or more
thin,
flexible
tubes
(catheters)
through an
artery,
usually in
the groin,
and guides
them to the
heart.
Sensors
(electrodes)
on the tip
of the
catheter use
heat
(radiofrequency)
energy to
create tiny
scars in the
heart to
block
irregular
electrical
signals and
restore the
heart
rhythm.
Self care
The following
self-care
strategies can
help control
premature
ventricular
contractions (PVCs)
and improve
heart health:
-
Track your
triggers. If
you have
frequent PVCs,
keeping a
diary of the
day and
timing of
symptoms may
be helpful.
A diary may
help
identify
foods,
drinks or
activities
that trigger
the
premature
ventricular
contractions.
-
Modify your
substance
use. Caffeine,
alcohol,
tobacco and
stimulant
drugs are
known
triggers of
premature
ventricular
contractions.
Reducing or
avoiding
such items
may reduce PVC symptoms.
-
Manage
stress. Anxiety
can trigger
irregular
heartbeats.
Find ways to
help reduce
emotional
stress.
Getting more
exercise,
practicing
mindfulness
and
connecting
with others
in support
groups are
some ways to
tame stress.
If you need
help
managing
anxiety,
talk to your
health care
provider
about
strategies
and
medications
that may
help.
Preparing
for your
appointment
You're likely to
start by seeing
your family care
provider. You
may be referred
to a doctor
trained in heart
diseases
(cardiologist).
Here's some
information to
help you get
ready for your
appointment.
What you can do
Make a list of:
-
Your
symptoms, how
they feel
and when
they began
-
Key medical
information, including
other recent
health
conditions
and family
history of
heart
disease
-
All
medications,
vitamins and
other
supplements you
take and
their
dosages
-
Questions to
ask your
health care
provider
Take a friend or
relative with
you, if
possible, to
help you
remember the
information you
receive.
For premature
ventricular
contractions,
questions to ask
your health care
provider
include:
- What is
likely
causing my
symptoms?
- What tests
do I need?
- What
treatment
approach do
you
recommend,
if any?
- What
lifestyle
changes can
I make to
reduce my
symptoms?
- Do I need to
eliminate
alcohol and
caffeine?
- Am I at risk
of long-term
complications?
- How will you
monitor my
health over
time?
- Do I need to
adjust the
medications
I'm taking
for other
health
conditions?
Don't hesitate
to ask other
questions.
What to expect
from your doctor
Your health care
provider is
likely to ask
you questions,
including:
- Do your
symptoms
come and go?
If so, when
are they
likely to
occur?
- Do you drink
alcohol? If
so, how
much?
- Do you use
caffeine? If
so, how
much?
- Do you smoke
or use other
nicotine
products?
- Do you use
illegal
drugs?
- How often do
you feel
stressed or
anxious?
What do you
do to manage
these
feelings?
Be ready to answer questions so that you
have time to talk about what's most important to you.
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