Premature Ventricular Contractions (PVCs)

Diagnosis

To diagnose premature ventricular contractions, a healthcare professional performs a physical examination and asks detailed questions about medical history and lifestyle habits. Listening to the heart with a stethoscope may reveal irregular beats that suggest PVCs. Because PVCs may not happen consistently, further testing is usually needed to confirm the diagnosis and identify possible causes.

Tests

Several tests are used to detect premature ventricular contractions and understand what may be triggering them.

• Electrocardiogram
  An electrocardiogram records the electrical activity of the heart and shows how it is beating at that moment. Sticky sensor patches are placed on the chest and sometimes on the arms and legs. These sensors connect to a computer that displays or prints the heart’s rhythm, allowing PVCs to be identified.

• Holter monitor
  A Holter monitor is a small, wearable device that continuously records heart activity, usually for 24 hours or longer. It is useful when PVCs do not occur frequently and may not appear on a standard electrocardiogram. Some wearable consumer devices, such as certain smartwatches, also offer portable heart rhythm monitoring.

• Event monitor
  An event monitor is another portable heart rhythm recorder that may be worn for up to 30 days. It is designed to capture irregular heartbeats when symptoms occur. In some cases, the wearer presses a button during symptoms, while other devices automatically record abnormal rhythms.

• Exercise stress test
  This test involves walking on a treadmill or riding a stationary bicycle while heart activity is closely monitored. An exercise stress test can help determine whether physical activity triggers premature ventricular contractions.

Treatment

Most people with premature ventricular contractions do not have underlying heart disease and do not require treatment. When heart disease is present or PVCs occur frequently and cause symptoms, treatment may be recommended. The treatment approach depends on the cause and severity of the condition.

Treatment for frequent premature ventricular contractions

When PVCs happen often or cause discomfort, several treatment options may be considered.

• Lifestyle changes
  Reducing or eliminating caffeine and avoiding tobacco use may decrease symptoms and reduce the number of irregular heartbeats.

• Medications
  Medications may be prescribed for frequent PVCs or when they are associated with other heart rhythm problems, such as ventricular tachycardia. Common options include beta blockers and calcium channel blockers, which help control abnormal electrical signals in the heart.

• Radiofrequency catheter ablation
  If lifestyle changes and medications do not reduce PVCs, a procedure called radiofrequency catheter ablation may be recommended. During this procedure, thin flexible tubes are guided through blood vessels to the heart. Heat energy is used to create small scars in specific areas of heart tissue, blocking the electrical signals responsible for the abnormal beats and helping restore a normal heart rhythm.