Filed under: Heart & Vascular
Premature ventricular contractions (PVCs) are extra, abnormal heartbeats that begin in one of your heart's two lower pumping chambers (ventricles). These extra beats disrupt your regular heart rhythm, sometimes causing you to feel a flip-flop or skipped beat in your chest. Premature ventricular contractions are very common — they occur in most people at some point.
Premature ventricular contractions are also called:
If you have occasional premature ventricular contractions, but you're an otherwise healthy person, there's generally no reason for concern, and no treatment is needed. If you have frequent premature ventricular contractions or underlying heart disease, you may need treatment to help you feel better and treat underlying heart problems.
Premature ventricular contractions often cause no symptoms. But you may feel an odd sensation in your chest, such as:
When to see a doctor
If you feel flip-flops, a sensation of skipped heartbeats or odd feelings in your chest, talk to your doctor. You'll want to identify the source of these symptoms. Premature ventricular contractions may be the problem, but other conditions also may be to blame, including other rhythm problems, serious heart problems, anxiety, anemia or infections.
Your heart is made up of four chambers — two upper chambers (atria) and two lower chambers (ventricles). The rhythm of your heart is normally controlled by the sinoatrial node (SA node) — or sinus node — an area of specialized cells located in the right atrium. This natural pacemaker produces the electrical impulses that trigger the normal heartbeat. From the sinus node, electrical impulses travel across the atria to the ventricles, causing them to contract and pump blood out to your lungs and body.
Premature ventricular contractions are abnormal contractions that begin in the ventricles. These extra contractions usually beat sooner than the next expected regular heartbeat. And they often interrupt the normal order of pumping, which is atria first, then ventricles. As a result, the extra, out-of-sync beats are usually less effective in pumping blood throughout the body.
Why do extra beats occur?
The reasons aren't always clear. Certain triggers, heart diseases or changes in the body can make cells in the ventricles electrically unstable. Underlying heart disease or scarring may also cause electrical impulses to be misrouted. Premature ventricular contractions may be associated with:
The following stimulants, conditions and triggers may increase your risk of premature ventricular contractions:
If you have frequent premature ventricular contractions or certain patterns of premature ventricular contractions, you may be at increased risk of developing heart rhythm problems (arrhythmias). Rarely, when accompanied by underlying heart disease, frequent premature contractions can lead to chaotic, dangerous heart rhythms and possibly sudden cardiac death.
You're likely to start by seeing your family doctor. However, in some cases when you call to set up an appointment, you may be referred to a doctor who specializes in the diagnosis and treatment of heart conditions (cardiologist).
Here's some information to help you prepare for your appointment.
What you can do
For premature ventricular contractions, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions that may occur to you during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:
What you can do in the meantime
While you wait for your appointment, check with your family members to find out if any relatives have been diagnosed with heart problems. Although premature ventricular contractions are usually harmless, the symptoms of this condition mimic those of many other cardiac illnesses. Knowing your family health history will help your doctor plan the right diagnostic tests and treatments, based on your individual risks.
It will also help your doctor to know what triggers your symptoms. In the time leading up to your appointment, take note of any substances or activities that seem to bring on the strange sensations in your chest.
If your doctor suspects that you have premature ventricular contractions, you may have an electrocardiogram (ECG). This test can detect the extra beats, identify their pattern and their source, and look for any underlying heart disease.
If you experience infrequent premature ventricular contractions, they may not be detected during the brief time a standard ECG is being done. You may need to use a Holter monitor or event recorder for 24 hours or more to capture any abnormal rhythms:
A Holter monitor or event recorder can help identify the pattern of your premature ventricular contractions. The occurrence of more than three premature ventricular beats in a row is called ventricular tachycardia — which can cause symptoms and be a sign of serious heart disease.
Most people with premature ventricular contractions and an otherwise normal heart won't need treatment. Rarely, if you have frequent, bothersome symptoms, you may be offered treatment to help you feel better, but PVCs are typically not harmful.
In some cases, if you have underlying heart disease that could lead to more serious rhythm problems, you may need to make efforts to avoid triggers or perhaps take medications.
If you have very frequent PVCs associated with underlying heart disease and periods of ventricular tachycardia, your doctor might recommend treatment for the underlying condition.
The following self-care strategies can help control premature ventricular contractions and improve your heart health: