Overview
Also known as ventricular ectopics, premature ventricular contractions (PVC) describe heartbeats that start in the Purkinje fibres rather than the sinoatrial node (SAN) resulting in a beat followed by a pause before the next heartbeat felt as a ‘skipped beat’.
Two consecutive PVCs are called doublets and three or more PVCs are classified as ventricular tachycardia and may require urgent management.
If PVCs alternate with a regular sinus beat, the patient is in bigeminy. If they occur every third beat, they are known as trigeminy.
Investigation
- ECG:
- May show a normal beat followed by an ectopic beat, then a PVC and so on
- This may appear as isolated wide QRS complexes on the background of an otherwise normal ECG
Management
Overview
Patients with PVCs at low risk do not require treatment. Other patients (such as those with heart disease) require regular follow-up and drug treatment with beta-blockers and radiofrequency ablation (if appropriate).
