Premature Ventricular Contractions (PVC)

1. Signs and Symptoms

1.1. Fluttering

1.2. Pounding or jumping heart

1.3. Skipped or missed beats

1.4. Increased awareness of heart beat

2. Pathophysiology

2.1. Ectopic beat that does not originate from the heart's natural pacemaker. They originate in the ventricles

2.2. Can disrupt regular heart rhythm

2.3. Very common

3. Risk Factors

3.1. Caffeine, tobacco, alcohol, illicit drugs

3.2. Exercise

3.3. Hypertension

3.4. Anxiety

3.5. Heart Disease

3.5.1. Congenital heart disease

3.5.2. Coronary artery disease

3.5.3. Heart failure/Digoxin use

3.5.4. Heart attack

3.5.5. Weakened heart muscle

4. Appearance of Rhythm

4.1. Premature and irregular shaped QRS complex. Wide >0.12 seconds

4.2. No P wave (no atrial impulse)

4.3. Large T wave orientated in opposite direction of QRS complex

4.4. Followed by a compensatory pause (heart resetting itself)

5. Treatments/Medications

5.1. Management

5.1.1. Eating healty

5.1.2. Exercise, healthy weight

5.1.3. Avoiding too much alcohol and caffeine

5.1.4. Avoiding too much stress

5.1.5. Getting adequate sleep

5.1.6. Treatment for other conditions (hypertension)

5.2. For frequent PVCs

5.2.1. Beta Blockers or Calcium Channel Blockers

5.2.2. Antiarrhythmics

5.2.3. Catheter Ablation

5.2.3.1. Uses radiofrequency energy to destroy area of heart tissue that is causing irregular contractions

6. Complications

6.1. PVC cause ventricles to contract before atria have emptied and ventricles have filled

6.1.1. Can create inefficient circulation (especially in those underlying heart disease or comorbid conditions)

6.2. Increased risk of sustained ventricular dysrhythmias such as Ventricular tachycardia, ventricular fibrillation, stroke and myocardial Infarction