Publish 25 November 2021
Too Many Heartbeats
Have you ever felt a ‘skipped’ or ‘extra’ heartbeat? An odd sensation that feels like a palpitation or pounding in the chest can follow it. You could be experiencing a premature ventricular contraction (PVC). Most people have PVCs at some point in their lives. Don’t let an isolated incident alarm you. A better understanding of what they are provides clues to when further investigation is necessary.
What Are Premature Ventricular Contractions?
PVCs are premature extra beats from the lower chambers of the heart. Their electrical activity does not originate in the normal heartbeat. This leads to disruption of your regular cardiac rhythm. Excessive PVCs are indicative of an underlying heart condition. Frequency impairs ventricular relaxation and increases the risk of atrial fibrillation (AFib). [1,2]
When amounting to 10–15% of total heartbeats, PVCs can be dangerous.  If you experience more than 5 PVCs per minute, consult a cardiologist or electrophysiologist. After treatment of causative factors, premature ventricular contractions often subside.
Why Do I Feel Extra Heartbeats?
Understanding the mechanism of a regular heartbeat is helpful. The human heart consists of four chambers: two atria, and two ventricles. Atria delivers the blood to the ventricle, which further pumps it to the rest of the body. The sinoatrial node (SA) is the electrical pacemaker of the heart. It creates electrical impulses that travel from atria to ventricles. These impulses contract atria and ventricles to supply blood to the rest of the body. The heartbeat that you feel is due to the contraction of the ventricle.
A PVC is a too-early heartbeat that does not originates from the sinoatrial node. It initiates from Purkinje fibers of ventricles. Therefore, PVCs occur before the regular heartbeat. The stronger heartbeat that follows creates the feeling of an extra beat.
What Are Risk Factors of PVCs?
Though more common in elderly men, PVCs can occur in any person at any age. Some drugs and medical conditions can induce premature contractions. Caffeine, alcohol, nicotine, and cocaine can cause too-early heartbeats (PVCs). Medications like antihistamines and decongestants may produce similar contractions. High levels of adrenaline in the body can also disrupt cardiac rhythm. Anxiety and nicotine help in the release of adrenaline in the body. Congenital heart diseases, myocardial infractions (heart attacks), and hypertension also produce premature ventricular contractions.
How PVCs Are Diagnosed?
Electrocardiogram (ECG) is the primary means of identifying premature ventricular contractions. The discovery of PVCs often occurs during a routine ECG for other medical conditions. You can experience mild to no symptoms during a PVC. The feeling may heighten during times of stress. Doctors do not consider isolated PVCs to be dangerous. The burden of continuous PVCs can pose grave health concerns.
Frequent premature ventricular contractions after heart attacks require remote cardiology monitoring.  One customer notes that Apple Watch Series 4 detected a benign PVC.  (You can enable irregular rhythm notifications for Apple Watch with no claims regarding diagnosis. This feature is not constantly looking for, and therefore cannot detect all, instances of AFib.) Fatigue or hyperventilation is common after strenuous activity. Symptoms of palpitation, lightheadedness, and chest pains can require prompt medical assistance.
⚠️ Apple iPhone 12 Safety Alert
Medical device interference. iPhone contains magnets as well as components and radios that emit electromagnetic fields. These magnets and electromagnetic fields may interfere with medical devices, such as pacemakers and defibrillators. Placing an iPhone 12 on or near chest, as in shirt or jacket pocket, can deactivate an implantable device. 
PVC Complications and Outlook
You may experience an uneventful PVC in your lifetime. When the incidence of PVCs is high, you should consult a cardiology professional. Frequent premature ventricular contractions can weaken your heart muscles.  Further escalation can develop cardiac arrhythmias or atrial fibrillation. Minimally invasive catheter ablation of chronic PVCs can restore normal heart function.
Premature ventricular contractions are manageable with proper care and treatment. Positive lifestyle changes like limiting your alcohol and caffeine intake can improve your heart health and lower risks of PVCs.
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- Agarwal SK, Simpson RJ Jr, Rautaharju P, et al. Relation of ventricular premature complexes to heart failure (from the Atherosclerosis Risk In Communities [ARIC] Study). Am J Cardiol. 2012;109(1):105-109. doi:10.1016/j.amjcard.2011.08.009
- Steve S. Rayan. Atrial Fibrillation and PVCs, How Do They Compare? (2020) a-fib.com/atrial-fibrillation-and-pvcs-how-do-they-compare/ Retrieved 25 Nov 2021
- How much should I worry about that ‘extra’ heartbeat? Penn State Health News. (2020) pennstatehealthnews.org/2020/02/the-medical-minute-how-much-should-i-worry-about-that-extra-heartbeat/ Retrieved 25 Nov 2021
- Gerstenfeld, EP, & De Marco, T. (2019). Premature Ventricular Contractions: Not Always Innocent Bystanders. Circulation, 140(8), 624-626.
- Apple Watch catches premature ventricular contraction, impressing doctor; deaf customer praises vibrating alarm clock and more. (2019) 9to5mac.com/2019/03/08/apple-watch-stories-benefits/ Retrieved 25 Nov 2021
- Ahn MS. Current Concepts of Premature Ventricular Contractions. J Lifestyle Med. 2013;3(1):26-33. ncbi.nlm.nih.gov/pmc/articles/PMC4390755/ Retrieved 25 Nov 2021
- Greenburg, JC, MD, Altiwil MR, MD, Singh, G, MD. Lifesaving Therapy Inhibition by Phones Containing Magnets. HeartRhythm. 2021 Jan 4. heartrhythmjournal.com doi:10.1016/j.hrthm.2020.12.032
- Main photo by Denys Prykhodov licensed from Adobe Stock.
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