Premature ventricular contractions (PVCs) are extra, abnormal heartbeats that begin in the lower chambers of the heart instead of the upper chambers.
What Are Premature Ventricular Contractions?
Premature ventricular contractions (PVCs) are extra, abnormal heartbeats that begin in the lower chambers of the heart (ventricles) instead of the upper chambers (atria). Although usually benign, PVCs can present with certain sensations in the chest as they .
Symptoms of PVCs are sometimes difficult to notice, but may present as feelings of fluttering or pounding in the chest, skipped or missed heartbeats, or an increased awareness of your heart beating.
Treatment for PVCs often includes at-home measures, such as managing stress and being aware of triggers from both substances and behaviors. More serious action is sometimes taken via medication or surgery.
If you are an otherwise healthy individual, there's generally no reason for concern as PVC's on themselves are not harmful. However, palpitations can be hard to distinguish from a more serious underlying heart issue, and therefore it is recommended to visit a doctor today to get an EKG done.
Symptoms of Premature Ventricular Contractions
PVCs cause symptoms that are subtle and sometimes do not cause symptoms at all. If you are experiencing PVCs, you may feel the following sensations in your chest:
- Skipped or missed beats
- Increased awareness of your heart beating
Complications of PVCs
Certain complications can arise due to PVCs, such as:
- Arrhythmias: Although PVCs are usually harmless, over time they can increase the risk of heart rhythm problems, which are called arrhythmias.
- Cardiomyopathy: The irregular beats of and cause dysfunction in how well the heart beats, which is a condition known as cardiomyopathy.
- Sudden cardiac death: In rare cases, when PVCs also occur in the setting of heart disease, they can lead to dangerous, chaotic heart rhythms that can lead to sudden cardiac death such as ventricular tachycardia or fibrillation.
Causes of Premature Ventricular Contractions
PVCs are primarily caused by abnormal, premature contractions or beats, as the name suggests. Details regarding how the heart normally beats and why PVCs may occur are described below.
How the heart normally beats
The heart is composed of four chambers two upper chambers called atria and two lower chambers called ventricles. In the right atrium, there is an area of specialized cells called the (also known as the sinus node) that is normally responsible for controlling the rhythm of your heart. The sinoatrial node paces the heart by producing the electricity that triggers the heart to beat. This electricity travels through both atria then down to the ventricles, causing the heart to contract and pump blood throughout the body.
What happens with PVCs
The normal order of pumping is the atria then the ventricles. However, sometimes an electrical pulse will begin in the ventricles and cause the heart to abnormally contract. These extra contractions often cause a beat that happens sooner than the next expected heartbeat. It is not entirely clear why these extra beats occur. Heart disease or metabolic changes in the body may cause cells in the ventricles to become electrically unstable and predisposed to firing.
Why PVCs may occur
Premature ventricular contractions are often associated with:
- Medications: Such as antihistamines and decongestants
- Alcohol use
- Illicit drug use
- Increased adrenaline: Caffeine, tobacco, exercise, or anxiety can cause this
- Injuries to the heart muscle: Conditions that can cause this include coronary artery disease, high blood pressure, heart failure, congenital heart disease, or cardiomyopathy
Treatment Options and Prevention
Most people with PVCs do not need treatment. At-home remedies and lifestyle changes can help control extra beats from PVCs. If these methods are not effective, certain treatments can be given by a medical provider.
At-home treatments and lifestyle changes
There are a few methods you can try at home, including:
- Modify substance use: Caffeine, alcohol, tobacco and other illegal or recreational drugs are known to cause PVCs. Reducing or eliminating these substances can help reduce your premature ventricular contraction symptoms.
- Manage stress: Stress can also trigger PVCs. If you are feeling anxious or on-edge, try techniques such as .
- Keep track of triggers: If you experience symptoms frequently, logging when your symptoms occur and being able to relate them to certain activities, foods, or days of the week can help you discover patterns and find ways to better control your symptoms.
Further medical treatment
If your PVCs continue to occur despite the remedies above, your physician may recommend the following options for treatment:
- Medications: Your physician may prescribe medications such as beta blockers, which can suppress premature contractions by controlling the heartbeat. Calcium channel blockers (CCBs), can also be used to control that interfere with your heart's normal function.
- Surgery: For PVCs that do not respond to lifestyle changes or medications, your physician may recommend a procedure called radiofrequency catheter ablation that uses radiofrequency energy to destroy the area of the heart that is causing the .
When to Seek Further Consultation
If you are experiencing symptoms of fluttering, pounding or skipped heartbeats
You should make an appointment with your physician promptly if you experience these symptoms. Although PVCs are common and usually benign, it is important to rule out and identify any underlying causes that need treatment, such as arrhythmias, heart disease, infections, and other medical conditions.
Questions Your Doctor May Ask to Diagnose
- How suddenly do your palpitations appear?
- How long do your palpitations usually last?
- Place two fingers under your jaw, as shown in the image. How is the rhythm of the heartbeat?
- Is your chest pain getting better or worse?
- How long has your chest pain been going on?
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- Larsson HP. How is the Heart Rate Regulated in the Sinoatrial Node? Another piece to the puzzle. J Gen Physiol. 2010;136(3):237-241. doi:10.1085/jgp.201010506.
- Agarwal SK, Simpson RJ, Rautaharju P, et al. Relationship of Ventricular Premature Complexes to Heart Failure (From the Atherosclerosis Risk in Communities [ARIC] Study). Am J Cardiol. 2012;109(1):105-109. doi:10.1016/j.amjcard.2011.08.009.
- Coping with Stress. Centers for Disease Control and Prevention. Published Dec. 4, 2017.
- YALIN K, GLCK E. Frequent Premature Ventricular Contractions and Cardiomyopathy, Chicken and Egg situation. J Atr Fibrillation. 2017;10(2):1674. doi:10.4022/jafib.1674.
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