[Premature ventricular complexes: what to do?]

Joëlle Régine Mekoa Mbarga1, Corinne Luczak2, Rodrigue Stettler3

  • 1Service de cardiologie, Département cœur-vaisseaux, Centre hospitalier universitaire vaudois, 1011 Lausanne.

Revue Medicale Suisse
|March 8, 2023
PubMed

Insights

Premature ventricular complexes (PVCs) are common heart rhythm disturbances. While often benign, they can signal underlying heart conditions or, even without structural heart disease, lead to cardiomyopathy.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Arrhythmology

Context:

  • Premature ventricular complexes (PVCs) are common arrhythmias in the general population.
  • PVCs can be associated with structural heart disease (SHD) of various etiologies (ischemic, hypertensive, inflammatory), serving as a prognostic indicator.
  • They may also occur in inherited arrhythmic syndromes or as idiopathic arrhythmias, often originating from ventricular outflow tracts like the right ventricle outflow tract (RVOT).

Purpose:

  • To discuss the clinical significance and potential etiologies of premature ventricular complexes.
  • To highlight the association of PVCs with underlying structural heart disease and inherited syndromes.
  • To address the potential for PVCs, even in the absence of SHD, to cause PVC-induced cardiomyopathy.

Summary:

  • Premature ventricular complexes (PVCs) are frequently observed arrhythmias with diverse origins, ranging from structural heart disease to idiopathic causes.
  • Idiopathic PVCs, often originating from the right ventricle outflow tract (RVOT), are typically considered benign but can be linked to PVC-induced cardiomyopathy.
  • The presence and burden of PVCs, irrespective of underlying structural heart disease, warrant careful consideration due to their potential prognostic implications and association with cardiomyopathy.

Impact:

  • Enhances understanding of the varied clinical presentations and underlying mechanisms of PVCs.
  • Provides insight into the prognostic value of PVCs in the presence of structural heart disease.
  • Raises awareness about PVC-induced cardiomyopathy as a potential consequence of frequent PVCs, even in the absence of other cardiac pathology.

Related Concept Videos

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
63
Dysrhythmias VI: Management of Dysrhythmias01:25

Dysrhythmias VI: Management of Dysrhythmias

Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
21
Dysrhythmias VII: Nursing Management of Dysrhythmias01:25

Dysrhythmias VII: Nursing Management of Dysrhythmias

Nursing management of dysrhythmias involves the following:AssessmentSubjective Assessment:The initial step involves gathering patient-reported symptoms such as dizziness, palpitations, and chest discomfort. It is crucial to collect a detailed history, including previous heart conditions, current medication use, and lifestyle factors like caffeine and alcohol consumption.Objective Assessment:This involves observing clinical signs such as jugular venous distention, cool and pale skin, and...
19
Disturbances in Heart Rhythm01:29

Disturbances in Heart Rhythm

Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
1.1K
Cardiomyopathy VI: Nursing Management01:29

Cardiomyopathy VI: Nursing Management

Assessment: Nursing management of patients with cardiomyopathy begins with a thorough assessment of the patient's history, including a family history of cardiomyopathy or sudden cardiac death, personal history of heart disease, hypertension, diabetes, and any alcohol consumption or drug use.During the physical examination, assess vital signs, look for signs of heart failure (such as edema, jugular venous distention, and cyanosis), auscultate for abnormal heart sounds (like murmurs and gallops),...
22
Dysrhythmias I: Introduction01:15

Dysrhythmias I: Introduction

Dysrhythmias refers to abnormalities in the heart's rhythm. They result from disruptions in the heart's electrical conduction system, which includes the sinoatrial(SA)node, atrioventricular(AV) node, the bundle of His, bundle branches, and Purkinje fibers.Definition and PathophysiologyDysrhythmias result from disorders of impulse formation, impulse conduction, or both. The heart contains specialized cells in the sinoatrial node, atrioventricular node, and the bundle of His and Purkinje fibers...
24