Premature Ventricular Contractions (PVCs)

Introduction

Premature Ventricular Contractions (PVCs) are extra heartbeats that originate in the ventricles of the heart. While PVCs are common and often harmless, they can sometimes indicate underlying heart disease or cause bothersome symptoms.

Causes and Risk Factors

PVCs can occur in healthy individuals as well as in people with heart disease. Some common causes include: - Electrolyte imbalances (low potassium, magnesium, or calcium) - Stress and anxiety - Caffeine, alcohol, or tobacco use - Heart disease (such as coronary artery disease, cardiomyopathy, or heart failure) - Medications or stimulants (such as decongestants or certain asthma drugs)

Symptoms of PVCs

Many people experience no symptoms, but when present, symptoms may include: - Sensation of a skipped or extra heartbeat - Heart palpitations - Dizziness or lightheadedness - Chest discomfort

Diagnosis

PVCs can be detected using: - Electrocardiogram (ECG) – A recording of the heart’s electrical activity. - Holter monitor – A wearable ECG device that records heart activity for 24-48 hours. - Echocardiogram – A heart ultrasound to check structure and function. - Electrophysiology studies (EPS) – Invasive testing to assess the electrical pathways of the heart.

Treatment

Most cases of PVCs require no treatment if the heart is otherwise healthy. However, if they are frequent or causing symptoms, the following approaches may be considered:

1. Lifestyle Modifications

• Reduce caffeine, alcohol, and tobacco.
• Manage stress and anxiety through relaxation techniques.

• Ensure a balanced diet rich in electrolytes.

  2. Medications

• Beta-blockers or calcium channel blockers may help reduce PVC frequency.

• In some cases, anti-arrhythmic medications may be prescribed if PVCs are severe.

  3. Catheter Ablation

• If PVCs are frequent and symptomatic, a procedure called catheter ablation may be considered to eliminate the abnormal electrical focus in the heart.

When to See a Doctor

Seek medical attention if you experience: - Frequent or persistent palpitations - Dizziness or fainting - Chest pain or shortness of breath - Worsening symptoms of heart disease

Conclusion

PVCs are common and usually harmless, but in some cases, they may indicate underlying heart problems. A proper diagnosis and management plan can help ensure optimal heart health.

Source recommendations

1. American Heart Association Guidelines for the Management of Arrhythmias

1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
2. https://www.heart.org/en/health-topics/arrhythmia
3. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
4. https://www.heart.org/en/health-topics/arrhythmia/prevention--treatment-of-arrhythmia
5. https://pubmed.ncbi.nlm.nih.gov/16949478/

2. 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