PREMATURE VENTRICULAR CONTRACTIONS

Definition
A premature ventricular contraction is an ectopic beat that may occur in healthy people without
causing problems. PVCs may occur singly, in clusters of two or more, or in repeating patterns,
such as bigeminy or trigeminy. When PVCs occur in patients with underlying heart disease, they
may indicate impending lethal ventricular arrhythmias.

Causes:
Acute MI or ischemia
Myocarditis
Cardiomyopathy, dilated or hypertrophic
Myocardial contusion
Hypoxia
Medications (eg, digoxin, sympathomimetics, tricyclic antidepressants, aminophylline,
caffeine)
Illicit substances (eg, cocaine, amphetamines, alcohol, tobacco)
Hypomagnesemia, hypokalemia,hyperkalemia, hypocalcemia

Signs and Symptoms
Patients are usually asymptomatic.
Cannon A waves or the increased force of contraction due to postextrasystolic potentiation of
contractility can cause palpitations and neck and/or chest discomfort.
The patient may report feeling that his or her heart "stops" after a PVC.
Patients with frequent PVCs or bigeminy may report syncope. This symptom is due to either
inadequate stroke volume or decreased cardiac output caused by the condition effectively
halving the heart rate.
Long runs of PVCs can result in hypotension.
.
Interventions
Procainamide (Pronestyl), amiodarone (Cordarone), or lidocaine IV
Potassium Chloride may be given to correct hypokalemia
Magnesium sulphate IV may be given to correct hypomagnesemia
Other treatments may be aimed at adjusting drug therapy or correcting acidosis,
hypothermia or hypoxia.