Premature Ventricular Beats
(Ventricular Premature Beats; Premature Ventricular Contractions; Ventricular Ectopic Beats)
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.
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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 for PVBs are:
Many people who have PVBs have 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.
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.
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
There are no guidelines to prevent PVBs. It may help to:
- Quit smoking
- Limit or not use caffeine and alcohol
- Marcus, G.M. 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.
- Understanding premature ventricular contractions (PVCs). Saint Luke's website. Available at: https://www.saintlukeskc.org/health-library/understanding-premature-ventricular-contractions-pvcs.
- 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.
- Nicole Meregian, PA
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