Ventricular premature contraction – VPC – PVC – VPB

Ventricular premature contraction – VPC – PVC – VPB

Ventricular premature contractions (VPC) are early beats originating from the lower chambers of the heart before the normal beat is expected. They are also known as premature ventricular contraction (PVC) and ventricular premature beats (VPB). VPCs are easily recognized on the ECG because they have a wide bizarre shape, quite different from the normal beats.

How dangerous are PVCs?

The risk of ventricular premature contraction depends on the setting in which it occurs. It is seen in several near normal individuals without any other structural heart disease. If they are infrequent, they may not be of much significance and left alone. But if they occur in large numbers, in rapid succession and in different shapes, more dangerous forms of abnormal heart rhythms like ventricular tachycardia or ventricular fibrillation may occur.

PVCs are more dangerous in the presence of structural heart disease, more so in the presence of reduced pumping function of the heart (left ventricular dysfunction). VPCs occurring in those with electrical disorders of the heart are also more risky.

Can you count the total number of VPCs in a day?

It is impossible to manually count the number of VPCs in a day because the total number of heart beats in a day nears about hundred thousand. Automatic counting is possible using a Holter monitor which can record ECG data for 24-48 hours and analyze it using a computer program in the Holter analyzer. Some consider more than 10% PVC among the total beats as the significant threshold level for active management.

How can PVCs be treated?

Isolated PVCs without structural heart disease and left ventricular dysfunction may be kept under follow up. There may be some benefit by avoiding stimulants like coffee, tea and alcohol. If they very frequent and showing risk factors for higher grades of rhythm disorders, they can be treated by medications. Those with associated heart failure should receive optimal medications for the same which can bring down the frequency of VPC. Some with frequent runs of VPC (ventricular tachycardia) may need electrophysiology study and radiofrequency catheter ablation. Those at risk of cardiac arrest will need protection by implanting an implantable cardioverter defibrillator.

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