Ectopic Ventricular Beats: Causes, Diagnosis, and Treatment

Introduction

Ectopic ventricular beats (EVBs), also called premature ventricular contractions (PVCs), are extra heartbeats that originate from the ventricles. These beats disrupt the heart's normal rhythm and can sometimes be felt as palpitations.

Causes of EVBs

EVBs can occur in healthy individuals and those with heart disease. Common causes include: - Heart conditions: Coronary artery disease, heart failure, myocarditis. - Electrolyte imbalances: Low potassium or magnesium levels. - Stimulants: Caffeine, nicotine, alcohol. - Stress and anxiety: Emotional stress and lack of sleep. - Medications: Certain drugs, including decongestants and asthma medications.

Diagnosis

A doctor may use several methods to confirm the presence of EVBs: 1. Electrocardiogram (ECG) – Detects abnormal heartbeats. 2. Holter monitoring – Records heart activity over 24-48 hours. 3. Echocardiogram – Evaluates heart structure and function. 4. Blood tests – Checks for electrolyte imbalances and thyroid problems.

Treatment Approaches

1. Lifestyle Modifications

  • Reduce caffeine, alcohol, and tobacco intake.
  • Manage stress through relaxation techniques.
  • Maintain a healthy diet rich in potassium and magnesium.

2. Medications

  • Beta-blockers (e.g., metoprolol) to reduce the frequency of EVBs.
  • Antiarrhythmic drugs in severe cases, under strict supervision.

3. Catheter Ablation

A minimally invasive procedure used if EVBs are frequent and symptomatic, especially if they contribute to left ventricular dysfunction.

4. Treat Underlying Conditions

If EVBs are caused by heart disease, treatment should focus on managing the primary condition.

Conclusion

Most EVBs are harmless and do not require treatment unless they cause symptoms or are associated with underlying cardiac disease. If you experience frequent palpitations or dizziness, consult a cardiologist for further evaluation.

Source recommendations

1. European Society of Cardiology Guidelines on Ventricular Arrhythmias and Sudden Cardiac Death

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
  2. https://academic.oup.com/eurheartj/article/43/40/3997/6675633
  3. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
  4. https://pubmed.ncbi.nlm.nih.gov/36017572/
  5. https://www.sciencedirect.com/science/article/pii/S2405500X22010945

2. American Heart Association Guidelines on Arrhythmias

  1. https://www.heart.org/en/health-topics/arrhythmia
  2. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
  3. https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia
  4. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
  5. https://pubmed.ncbi.nlm.nih.gov/29084733/

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