Cardiology

Premature Ventricular Contractions

Apple Watch heart monitor

Occurring occasionally, Premature Ventricular Contractions can resolve on their own. Occurring frequently, PVCs can signal more serious conditions.

Publish 25 November 2021

Too Many Heartbeats

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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 accounting for 10–15% of total heartbeats, PVCs can be dangerous. [3] If you experience more than 5 PVCs per minute, consult a cardiologist or electrophysiologist. After the 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 the atria to the ventricles. These impulses contract the 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 originate from the sinoatrial node. It originates from the Purkinje fibers of the 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 are PVCs Diagnosed?

An 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.

PVC electrocardiograph
ECGs depict narrow and wide PVCs. A: Patient with a narrow left bundle branch/inferior axis PVC. The patient had normal left ventricular (LV) function with persistent palpitations despite trials of metoprolol and flecainide. Ablation was performed successfully in the right parahisian region. B: A right bundle branch/superior axis PVC. This PVC is wider, and the patient had developed a cardiomyopathy with an ejection fraction of 42%. PVC ablation on the posteromedial papillary muscle resulted in complete restoration of normal LV function. [4]

Frequent premature ventricular contractions after heart attacks require remote cardiology monitoring. [5] One customer notes that Apple Watch Series 4 detected a benign PVC. [6] (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 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 the chest, as in a shirt or jacket pocket, can deactivate an implantable device. [7]

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. [6] 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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To support the writing of useful articles about cardiology, ClinicalPosters sells human anatomy charts, scientific posters, and other products online. You may sponsor specific articles or remit a small donation.

ClinicalPosters sells human anatomy charts, scientific posters, and other products online to offset expense of the writing useful articles about cardiology. Slide extra posters into DeuPair Frames without removing from the wall.

ClinicalPosters sells human anatomy charts, scientific posters, and other products online. You may remit a small donation or become a ClinicalNovellas Member.

You can support the writing of useful articles about cardiology by sponsoring specific articles, becoming a ClinicalNovellas Member, or remitting a small donation. Visible content is optimized for device size.

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