Ventricular Premature Beat (Premature Ventricular Contraction)

A ventricular premature beat, which is also called premature ventricular contraction, is an abnormal but usually harmless extra beat caused by a rogue electrical impulse starting in the ventricles prior to a normal heartbeat.

• Perception of an occasional strong heart beat or of a sporadic skipped beat is the usual symptom.

• Diagnosis is by electrocardiography and further tests may help rule out other heart defects.

• Stressful situations and mild stimulants like coffee and alcohol are better avoided.

More commonly occurring in older people, ventricular premature beat is generally the result of stress, either physical or emotional or it may be triggered by mild stimulants such as alcohol or coffee or by the use of certain drugs like pseudoephedrine contained in anti-allergic medications.
Heart valve disorders that result in enlargement of ventricles, as well as heart failure, may be reason for this condition. Coronary artery disease, soon after a heart attack especially, also may precipitate this arrhythmia.

Symptoms and Diagnosis

Ventricular premature beats are generally asymptomatic except for a feeling of having skipped a heart beat or an extra strong beat. Since they do not affect the pumping mechanism of the heart, they are usually ignored unless very frequent episodes become disconcerting. Though ventricular premature beats are not dangerous in themselves, frequent episodes, especially in people with pre-existing heart defects, they may be precursors of potentially fatal arrhythmias such as ventricular fibrillation and ventricular tachycardia that call for immediate intervention.

Ventricular premature beats can be diagnosed by electrocardiography (ECG) and further tests can rule out any other underlying heart defects.

Treatment

Usually doctors do not prescribe any drugs for people with ventricular beats if they are otherwise healthy, but often advise them to avoid caffeinated beverages and other mild stimulants such as alcohol and anti-allergic medications, in addition to reducing stress.

Beta-blockers are sometimes prescribed to treat the condition if the symptoms cause extreme discomfort or when there is a possibility of developing ventricular fibrillation or tachycardia. But the side effects of these drugs such as drowsiness often discourage people from taking them. However, if people with this condition, have also had heart attacks, the risk of developing fatal arrhythmias like ventricular fibrillation can be greatly reduced by taking beta blockers. Certain structural defects of the heart and certain patterns in which ventricular premature beats occur can predispose a person to developing more serious and often fatal arrhythmias. Bypass surgery or angioplasty to treat coronary artery disease also may reduce the risk of sudden death due to potentially fatal arrhythmias. Antiarrhythmic drugs can also help but they are associated with a greater risk of developing more dangerous arrhythmias, so doctors prescribe them after careful evaluation only.

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