To Beat or Not to Beat: When and How to Treat Premature Ventricular Complexes

Premature ventricular complexes (PVCs) are prevalent arrhythmias and a common reason for cardiac consultation. While often benign, PVCs can be markers of underlying heart disease and result in significant symptoms, left ventricular dysfunction, and in rare cases sudden cardiac death. The evaluation of a patient with PVCs should answer two essential questions: (a) Is the arrhythmia benign or it is a manifestation of a more serious heart condition? (b) Does the patient require specific therapy to suppress the PVCs? This review focuses on risk stratification of patients to identify who may benefit from further evaluation and the clinical scenarios wherein treatment of PVCs should be considered.