Workup and management of patients with frequent premature ventricular contractions.

Abstract

Premature ventricular contractions (PVCs) are a frequently encountered entity in clinical cardiology. They rarely affect prognosis or management. However, they might produce bothersome symptoms and, in select individuals with a high PVC burden, they might contribute to left ventricular (LV) dysfunction. Workup of patients with very frequent PVCs consists of a thorough history and physical examination to screen for underlying cardiac disease and potential triggers. Routine investigations include a standard 12-lead electrocardiogram, as well as an echocardiogram. A Holter monitor should be performed in those with severe symptoms, a history of syncope, or a malignant family history. Exercise stress testing has a role in evaluating for ischemia and in the assessment of patients with exertional symptoms. More advanced testing is not warranted if these initial investigations are reassuring. Referral to an arrhythmia specialist should be considered in patients with LV dysfunction whose PVC burden exceeds 15%. Frequent ventricular ectopy represents a rare, but reversible cause of LV dysfunction and these patients should be further evaluated for possible catheter ablation.

• Authors: Katie Giles, Martin S Green
• Journal: The Canadian journal of cardiology (Can J Cardiol) Vol. 29 Issue 11 Pg. 1512-5 (Nov 2013) ISSN: 1916-7075 [Electronic] England
• PMID: 24182757 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Chemical References

• Adrenergic beta-Antagonists
• Anti-Arrhythmia Agents

Topics

• Adrenergic beta-Antagonists (therapeutic use)
• Anti-Arrhythmia Agents (therapeutic use)
• Catheter Ablation
• Echocardiography
• Electrocardiography
• Exercise Test
• Humans
• Medical History Taking
• Physical Examination
• Prognosis
• Ventricular Dysfunction, Left (etiology, therapy)
• Ventricular Premature Complexes (diagnosis, therapy)