PREMATURE VENTRICULAR CONTRACTIONS ECGdoctkhalil
Premature ventricular contractions are ectopic electrical activity in the heart that are associated with an abnormal rhythm. The origin of these PVCs is ventricular. The ventricles are the lower 2 chambers of the heart. PVCs can be an incidental finding on EKG. This means that the person may not feel any symptoms in relation to these occurring , in most cases. However, they can be symptomatic and present with palpitations, shortness of breath and a feeling of skipping a beat and disturbed rhythm.
The main associations that need to be taken care of and worked up whenever PVCs are seen include hypoxic conditions, electrolyte abnormalities and hyperthyroidism. Magnesium and potassium levels can be advised and if any electrolyte imbalance is found then it should be corrected , accordingly. Thyroid function tests and a history of cardiac/ rhythm abnormalities should also be taken.
EKG appearance of a PVC is markedly different from a normal QRS complex preceded by a p wave and followed by a T wave. The QRS is markedly wide without the presence of a p wave preceding it. It is also followed by a compensatory pause.
In symptomatic individuals, with palpitations and tachycardia , beta blockers can be advised. Use of anti arrhythmic drugs is controversial. Premature ventricular contractions are better left untreated if there is no underlying cause that is associated with the above conditions. If the electrolytes are normal, there is no ischemic heart disease and thyroid status is also fine then treating EKG findings alone may lead to more harm and complications than benefit.
With recent experience and trials , PVCs associated even with myocardial infarction are best left alone. They shouldn’t be treated with anti arrhythmic drugs. There is no need for a pacemaker as well. In short, premature ventricular contractions are not a normal finding on EKGs and one wouldn’t like to have them as they can be associated with later development of arrhythmias but they aren’t treated. Underlying causes should be addressed as compared to the PVC, itself.
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