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by Scholten A
(Ventricular Premature Beats; Premature Ventricular Contractions; Ventricular Ectopic Beats)

Definition

A premature ventricular beat (PVB) is an extra heartbeat. It starts in the lower heart chambers before a normal heartbeat. A PVB interrupts the heart’s normal rhythm. It causes a pause before the next heartbeat.

PVBs are common. In healthy people they are harmless. However, after a heart attack or heart surgery, PVBs can lead to harmful heart rhythms.

Anatomy of the Heart
IMAGE
Copyright © Nucleus Medical Media, Inc.

Causes

PVBs happen when normal heart signals are disrupted. It is not always clear why this happens. Certain health conditions and drugs can cause PVBs.

Risk Factors

Risk factors for PVBs are:

  • Medicines that stimulate the heart
  • Heart diseases such as:
  • Lung problems
  • Endocrine problems, such as thyroid disease
  • Emotional stress
  • Physical activity
  • Caffeine, alcohol, tobacco, and other drugs

Symptoms

In many cases, there are no symptoms. When symptoms happen, they may be:

  • Feeling the heart beating (palpitations)
  • Feeling a skipped or missed heartbeat

In people with heart disease, PVBs can cause lightheadedness and fainting.

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. Diagnosis may be based on symptoms and tests.

Tests may include:

  • Blood tests—to look for substances that could cause PVBs
  • ECG—tests the electrical activity of the heart
  • Holter monitor—a device worn to measure heart activity over 24 to 48 hours
  • Exercise test—to see if symptoms happen during physical activity
  • Echocardiogram—images of the heart and surrounding structures

Other tests may be done to look for causes.

Treatment

Many people do not need treatment for PVBs. It depends on how severe the symptoms are. It also depends on if a person has other heart problems.

Options may be:

  • Lifestyle changes, such as:
    • Stress management
    • Not using caffeine, alcohol, and tobacco
  • Changing medicines—if current medicines are causing PVBs

Some have worse symptoms or heart problems. They may need medicines to adjust the heart signals, such as:

  • Beta blockers
  • Calcium channel blockers
  • Antiarrhythmic agents

Prevention

There are no guidelines to prevent PVBs. It may help to:

  • Quit smoking
  • Limit or not use caffeine and alcohol

RESOURCES

American Heart Association  http://www.heart.org 

Heart Rhythm Society  http://www.hrsonline.org 

CANADIAN RESOURCES

Canadian Heart Rhythm Society  http://www.chrsonline.ca 

Heart and Stroke Foundation of Canada  http://www.heartandstroke.ca 

References

Marcus GM. Evaluation and management of premature ventricular complexes. Circulation. 2020;141(17):1404-1418.

Premature ventricular contractions (PVCs). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/premature-ventricular-contractions-pvcs. Accessed September 13, 2021.

Understanding premature ventricular contractions (PVCs). Saint Luke's website. Available at: https://www.saintlukeskc.org/health-library/understanding-premature-ventricular-contractions-pvcs. Accessed September 13, 2021.

Ventricular premature beats (VPB). Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/cardiovascular-disorders/arrhythmias-and-conduction-disorders/ventricular-premature-beats-vpb. Accessed September 13, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Nicole Meregian, PA
  • Review Date: 07/2021
  • Update Date: 09/13/2021