Overview
Premature ventricular contractions (PVCs) are extra heartbeats that originate from one of the heart's two lower pumping chambers (ventricles). These extra beats disrupt the regular heart rhythm, often causing a sensation of fluttering, pounding, or skipped beats in the chest. PVCs are a common type of irregular heartbeat (arrhythmia) and may also be referred to as premature ventricular complexes, ventricular premature beats, or ventricular extrasystoles. The cause of PVCs isn't always clear, but they can be associated with heart diseases or changes in the body that make cells in the lower heart chambers electrically unstable, potentially leading to misrouted heart signals.
Understanding the disease
Symptoms
The main symptom of premature ventricular contractions (PVCs) is an unusual sensation in the chest, such as fluttering, pounding, or jumping. Some people may also experience skipped or missed beats. However, PVCs often cause few or no symptoms. If the contractions are frequent, bothersome, or occur alongside an underlying heart condition, medical attention may be necessary.
Risk Factors
Risk factors for developing premature ventricular contractions (PVCs) include caffeine, tobacco, alcohol, stimulants such as cocaine or methamphetamines, exercise in certain types of PVCs, anxiety, heart attack, heart disease (including congenital heart disease, coronary artery disease, heart failure, and a weakened heart muscle/cardiomyopathy), a previous episode of ventricular fibrillation, a previous heart attack, a heart problem present at birth (congenital heart defect), heart muscle disease (cardiomyopathy), injuries that cause damage to the heart muscle, severe imbalance of potassium or magnesium, and drug misuse, particularly with cocaine or methamphetamine.
Development
Premature ventricular contractions (PVCs) develop when the heart's electrical signals are disrupted, causing the ventricles to contract too early. This can lead to a sensation of a fluttering, pounding, or skipped heartbeat. The cause of PVCs is not always clear, but certain factors can contribute, such as heart disease or scarring, lifestyle choices like caffeine, tobacco, alcohol, or stimulant use, and underlying health conditions like anxiety, heart attack, heart disease, or a weakened heart muscle. Premature ventricular contractions can be classified as premature ventricular complexes, ventricular premature beats, or ventricular extrasystoles, depending on their specific characteristics. Treatment for PVCs is usually only necessary if the contractions are frequent, bothersome, or accompanied by an underlying heart condition.
Assessment and Diagnosis
Triage
You should see a doctor if you feel fluttering, pounding, or a sensation of skipped heartbeats in your chest, as these symptoms may be due to premature ventricular contractions (PVCs) or other heart conditions. If PVCs are causing frequent, bothersome, or irregular symptoms, or if you have an underlying heart condition, you might need treatment. It's essential to consult a health care provider or a heart doctor (cardiologist) for further evaluation and guidance.
Diagnosis
To diagnose premature ventricular contractions (PVCs), a healthcare provider will typically listen to your heart with a stethoscope, and may ask questions about your lifestyle habits and medical history. An electrocardiogram (ECG or EKG) is the most common test used to diagnose PVCs. The ECG is a quick and painless test that records the heart's electrical activity, and can detect the extra beats and identify the pattern and source. If PVCs occur rarely, a portable ECG device may be used at home to obtain more information about your heartbeats.
Management and Treatment
Complications
Complications of premature ventricular contractions (PVCs) may include:
- Development of irregular heart rhythms (arrhythmias): Having frequent PVCs or specific patterns of them may increase the risk of developing irregular heart rhythms.
- Weakening of the heart muscle (cardiomyopathy): Persistent or frequent PVCs can sometimes lead to weakening of the heart muscle over time, potentially resulting in heart failure.
- Rare cases of sudden cardiac death: In individuals with heart disease, frequent premature contractions can sometimes cause chaotic and dangerous heart rhythms, which may result in sudden cardiac death. It is important to consult a healthcare professional if you experience frequent or bothersome PVCs, or if you have an underlying heart condition. Treatment may be necessary to manage symptoms and reduce potential complications.
Treatment
Treatment for premature ventricular contractions (PVCs) depends on the underlying cause and the severity of symptoms. In many cases, PVCs do not require specific treatment if they are infrequent and not causing any significant discomfort or complications. However, if PVCs are frequent, disruptive, or accompanied by other symptoms, various treatments may be considered.
- Medications: Certain medications may be prescribed to help control or prevent premature ventricular contractions. Antiarrhythmic medications can be used to help regulate the heart rhythm and prevent recurrences of PVCs.
- Lifestyle modifications: Making lifestyle changes may help reduce the risk of developing PVCs or prevent recurrent episodes. Quitting smoking, limiting caffeine and alcohol intake, and exercising regularly may be recommended. In some cases, avoiding certain trigger factors, such as stress or anxiety, may also be helpful.
- Cardioversion: This is a medical procedure that can be performed to restore a normal heart rhythm. A short electrical shock is administered to the heart, resetting the electrical activity and stopping the PVCs. This may be done on an outpatient basis or during an emergency situation.
- Catheter ablation: In some cases, a minimally invasive procedure called catheter ablation may be recommended. This involves using long, thin tubes (catheters) to deliver energy to the specific areas of the heart that are causing the PVCs. This can disrupt the abnormal electrical signals and prevent further PVCs from occurring.
- Implantable devices: For some people with frequent or severe PVCs, an implantable device may be recommended. This may include a pacemaker or implantable cardioverter-defibrillator (ICD). These devices can help regulate the heart rhythm and prevent life-threatening complications. It is important to consult with a healthcare professional to determine the most appropriate treatment approach based on individual circumstances and medical history.
Preparing for medical consultation
To prepare for an appointment regarding premature ventricular contractions (PVCs), you should:
- Be aware of any pre-appointment restrictions: At the time you make the appointment, inquire about any advance preparations or instructions, such as altering your diet or medication.
- Note any symptoms: Record any symptoms you're experiencing, including those that might seem unrelated to PVCs.
- Gather personal information: Compile information about your medical history, any family history of heart rhythm disorders or heart disease, and any recent life changes or stressors.
- List medications and supplements: Make a list of all prescription, over-the-counter, and supplements you are currently taking.
- Bring a support person: If possible, bring a family member or friend to the appointment, as they can help remember important information and provide emotional support.
- Prepare questions: Compile a list of questions to ask your healthcare provider about your PVCs, such as the cause, treatment options, and potential complications. Remember to be open and honest with your healthcare provider about your concerns and symptoms. They will be able to provide guidance and develop a plan tailored to your specific situation.