Premature Ventricular Contractions (cont.)
Daniel Lee Kulick, MD, FACC, FSCAI
Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.
Dennis Lee, MD
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What are premature ventricular contractions (PVCs)?
- What happens during a premature ventricular contraction?
- How common are premature ventricular contractions?
- What causes premature ventricular contractions?
- What are premature ventricular contraction symptoms?
- What are the dangers of premature ventricular contractions?
- How is premature ventricular contraction diagnosed?
- What are the treatments for premature ventricular contractions?
- Find a local Cardiologist in your town
What are the treatments for premature ventricular contractions?
The reasons for treating premature ventricular contractions are:
- to relieve symptoms of palpitation;
- to treat conditions
that cause premature ventricular contractions since many conditions that cause
premature ventricular contractions are potentially life
threatening; and
- to prevent ventricular tachycardia and sudden death.
In healthy individuals without heart disease, premature ventricular contractions need no treatment. For relief of palpitations, one may consider the following measures:
- stop alcohol and caffeine intake;
- stop over-the-counter
nasal decongestants that may contain
adrenaline such as
medications containing pseudoephedrine (certain weight loss supplements may aggravate
premature ventricular contractions, and should never be used without consulting with one's physician);
- stop drug abuse such as amphetamines, cocaine;
and
- stop cigarette smoking.
Conditions that can cause premature ventricular contractions can also be potentiality life-threatening. These conditions are often treated in hospital-monitored beds. Monitored beds are beds (or rooms) that are equipped to record the patients' heart rhythm continuously. Patients are also given intravenous medications. These conditions are:
- low potassium or magnesium
levels (hypokalemia and hypomagnesemia) - potassium and magnesium can be
given intravenously;
- digoxin and aminophylline toxicity: medications can be given to counteract drug toxicity;
- acute heart attack: medications and procedures (coronary angiogram and
PTCA) are performed urgently to open blocked coronary arteries to
restore blood supply to the heart muscle; and
- low blood oxygen levels (hypoxia): oxygen can be given nasally, and medications can be given to treat the underlying lung diseases.
Anti-arrhythmia medications
Anti-arrhythmia medications are used to control premature ventricular contractions with the goal of preventing ventricular tachycardias, ventricular fibrillations, and sudden death. Examples of anti-arrhythmia medications include beta-blockers, procainamide (Pronestyl, Procan-SR, Procanbid), amiodarone (Cordarone), and several others. Unfortunately, there is little scientific evidence that suppressing premature ventricular contractions with anti-arrhythmic medications prevent ventricular tachycardias, ventricular fibrillations, and sudden death.
Some anti-arrhythmia medications actually can cause abnormal heart rhythms. Thus anti-arrhythmic medications are only prescribed cautiously in patients at high risk of developing ventricular tachycardia and ventricular fibrillation; and usually initially in the hospital setting. This does not apply to beta-blockers, which are prescribed to many heart patients for many reasons, and not only do not accelerate arrhythmias, but usually decrease premature ventricular contractions. In many patients with premature ventricular contractions and significant underlying cardiac disease, or with severe symptoms, electrophysiology testing (EP) may be recommended. This is a test performed with catheters to see if a patient is at risk of life-threatening ventricular arrhythmias, which are treated with either medications or sometimes tiny implantable defibrillators.
Previous contributing author: Dennis Lee, MD
Last Editorial Review: 10/29/2009
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