Premature Ventricular Contractions (PVCs)

– The information has been reviewed by Dr. Lo Ka Yip, David

Frequent fluttering or pounding of the heart may be a sign of premature ventricular contractions, Also known as ventricular ectopic beats (VEBs)

When we are nervous or anxious, our heartbeats suddenly become more noticeable – sometimes, it may even feel like a heavy thud in our chest. Experiencing sporadic heart palpitations is considered normal, but for those who often encounter irregular heartbeats for no apparent reason, they may be suffering from premature ventricular contractions (PVCs). As its name suggests, a PVC is a premature heartbeat – it is like listening to a rhythmic song that suddenly misses a beat. People with PVCs may experience no symptoms at all, or may feel like their heart skips a beat from time to time. Some may notice their heart is beating irregularly, or feel a sudden thud or pounding. To detect PVCs, some people have suggested using an electronic watch to measure the heart rate, but at the end of the day, watches are not medical devices. If you are experiencing irregular heartbeats, it is always best to seek professional medical advice to better understand the status of your heart health.

Causes

PVCs are not rare and are in fact one of the most common types of arrhythmia. There are numerous causes, including excessive consumption of caffeine and existing heart problems such as cardiovascular disease, myocarditis, and heart failure.

An electrocardiogram (ECG) is generally used to detect PVCs, but for some patients, a Holter monitor (a portable ECG worn for 24 hours or more) may be required to confirm a PVC diagnosis. Following diagnosis, the doctor will need to identify the source or cause of the condition. If the PVCs are not a result of problems with the heart structure, the doctor may suggest reducing intake of caffeine or long-term medications that may be affecting the heart rate to see if this improves the overall condition.

Treatment

Patients with PVCs that are not caused by structural heart problems and display no symptoms may only need to monitor their condition. For those with mild symptoms but whose PVCs are unrelated to structural heart issues, the doctor may prescribe medications to reduce the premature contractions. If a patient’s PVCs are related to structural heart issues, the doctor will need to determine the source of the problem and recommend further treatment, the details of which will not be discussed here.

In severe cases, some patients experience PVCs in up to 10% of their total heartbeats (meaning one premature contraction in every 10 beats), while others may even see their PVCs affect their heart function, leading to heart failure. These patients may need to consider radiofrequency catheter ablation, a procedure where a catheter is threaded through a vein in the groin to the heart. Electrodes on the catheter use heat to destroy abnormal tissue, block irregular electrical signals, and restore the rhythm of the heart. The procedure is generally effective, and patients will need to attend follow-up consultations regularly. If they no longer experience PVCs, they may return to their normal lives and activities.

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