Premature Ventricular Contractions

What are premature ventricular contractions?

Premature ventricular contractions (PVCs) are a type of irregular heartbeat. They occur when the electrical signal that starts your heartbeat comes from one of your bottom two heart chambers (ventricles). The signal typically starts in the top right chamber (atrium).

PVCs are not always a problem. But if they repeatedly happen for months or years, they can cause a type of cardiomyopathy, or heart muscle weakening. PVCs usually go away with medication or other minimally invasive treatments.

Some people call premature ventricular contractions “pre ventricular contractions.” Healthcare providers may also refer to them as:

• Premature ventricular complexes.
• Ventricular extrasystoles.
• Ventricular premature beats.

How do electrical signals control your heartbeat?

Typically, in your heart conduction system, a cluster of cells in your right atrium called the sinoatrial (SA) node sends out the first electrical signal of a heartbeat. That signal moves through your heart and travels to your left and right ventricles. It tells your heart to contract.

In PVCs, that first signal starts in one of your ventricles. As a result, the signal travels differently through your heart and causes an irregular heartbeat. Sometimes, a PVC may feel like your heart “skipped a beat.”

Who is most likely to have premature ventricular contractions?

PVCs can happen in anyone, but they’re more common in older adults and those with heart disease. Your risk for PVCs also increases if you have:

• Heart failure.
• High blood pressure (hypertension).
• History of heart attacks.
• Hypertrophic cardiomyopathy.

How common are premature ventricular contractions?

PVCs are quite common. Up to 75% of people experience them.

Are PVCs something to worry about?

Many people don’t have any symptoms or health problems associated with PVCs. But if you do experience symptoms, speak with your healthcare provider. You may need treatment to prevent heart problems such as cardiomyopathy.

Are PVCs life-threatening?

PVCs typically aren’t life-threatening. But they may damage your heart muscle if they repeatedly occur for a long period.

What are the symptoms of premature ventricular contractions?

Many people don’t experience any symptoms of a PVC. If you have symptoms, they’re usually minor and may include:

• Dizziness.
• Feeling close to fainting.
• Heart palpitations.
• Pounding sensations in the neck.

If you have another heart condition, you may notice that a PVC causes shortness of breath (dyspnea). You may also notice more symptoms as you have more PVCs.

What do premature ventricular contractions feel like?

Many people describe premature ventricular contractions as a heart flutter and skipped beat. But you may not feel any symptoms at all. Most people don’t feel a premature ventricular contraction.

What causes premature ventricular contractions?

Several conditions or factors can trigger a premature ventricular contraction, including:

• Electrolyte imbalances, such as low potassium or magnesium.
• Heart attack (myocardial infarction).
• Heart failure.
• High adrenaline, such as from anxiety or stress.
• Reduced blood flow to your heart, such as in coronary artery disease.

How are premature ventricular contractions diagnosed?

Your healthcare provider asks you about your symptoms and health history and performs a physical exam. They may listen to your heartbeat with a stethoscope to check for signs of irregularities.

Usually, the first test is an electrocardiogram (EKG). An EKG measures your heart rate and evaluates the electrical signals in your heart. Your provider usually can see an arrhythmia or extra beats clearly on an EKG.

Sometimes, you may wear a Holter monitor or another type of heart monitor to measure your heart’s electrical activity over several days. Measuring your heart rhythm and heart rate over a few days can help detect infrequent PVCs.

What tests can diagnose causes of PVCs?

Your provider may recommend other tests if you have many PVCs or have had them for a long time. These tests check for root causes of PVCs, including other heart problems. You may have:

• Blood tests that evaluate your potassium and thyroid hormone levels.
• Cardiac stress testing that measures your heart rate and blood flow through your heart arteries during exercise.
• Cardiac MRIs or CT scansthat look at your heart’s structure, function and blood flow.
• Coronary angiograms that show your heart’s blood vessels to help identify irregularities in blood flow, including blocked or narrowed blood vessels.
• Echocardiograms (echo) that allows a visual assessment of your heart function, valvular heart function, and how blood flows through your heart chambers.
• Electrophysiology studies that analyze the electrical activity in your heart.

How are premature ventricular contractions treated?

People who have infrequent PVCs may not need any treatment. Treatment for underlying heart conditions may decrease the frequency of PVCs. For example, you may take medicines to reduce blood pressure or lower your heart rate. These medicines may also reduce how often you experience PVCs.

Sometimes, your provider offers specific PVC treatment. You only need treatment specifically for a PVC if you have frequent irregular heartbeats that could damage your heart muscle. Treatment may include:

• Catheter ablation, a minimally invasive procedure that strategically destroys the part of your heart causing irregular heartbeats.
• Medications, such as antiarrhythmics to decrease irregular heart rhythms, or beta-blockers or calcium channel blockers to lower blood pressure.

How can I prevent premature ventricular contractions?

There’s no way to prevent premature ventricular contractions. But you may increase your overall heart health by:

• Achieving and maintaining an ideal weight for your height, sex and body type.
• Avoiding tobacco completely and limiting your intake of other substances such as alcohol and caffeine.
• Eating a balanced heart-healthy diet with plenty of fruits, vegetables and whole grains.
• Exercising regularly, including aerobic exercise, strength training and stretching.
• Maintaining healthy cholesterol and blood pressure.
• Managing anxiety and stress with healthy coping tools, such as talk therapy or meditation.
• Sleeping at least seven hours nightly.

How do I know if I’m at risk of premature ventricular contractions?

Several factors can increase your risk of premature ventricular contractions, including:

• Diagnoses of other heart conditions, including congenital heart defects.
• Family history of arrhythmias.
• Previous heart attacks.

What is the outlook for premature ventricular contractions?

Generally, premature ventricular contractions have a positive outlook. They don’t increase the risk of health complications in most people.

Your risk of health complications, including a shorter lifespan, increases if you have other health problems or a history of heart attacks.

What questions should I ask my healthcare provider?

If you have premature ventricular contractions or think you could, you may also want to ask your healthcare provider:

• What is the most likely cause of premature ventricular contractions?
• Could another health condition be causing these symptoms?
• Do I need tests to check for underlying heart conditions?
• What tests do I need to diagnose premature ventricular contractions?
• Do I need treatment for premature ventricular contractions?
• What are the signs that a premature ventricular contraction is getting worse?
• Will premature ventricular contractions go away after treatment?

When should I go to the emergency room?

PVCs aren’t usually an emergency. Call 911 and go to your nearest emergency center if you experience other symptoms along with PVCs, including:

• Dizziness or passing out (syncope).
• Lightheadedness.
• Pain in your chest, neck, jaw or arms.
• Shortness of breath (dyspnea).
• Sudden confusion (delirium).

Can a PVC cause sudden death?

PVCs can increase your risk of sudden cardiac death if you have underlying structural heart disease or if they arise from specific areas in your heart. However, in most people, PVCs are benign and don’t lead to sudden cardiac death.

Can other health conditions cause similar symptoms to PVCs?

Yes. Heart fluttering, pounding and other symptoms may be signs of other health conditions such as:

• Anemia (low red blood cells).
• Anxiety disorders or a panic attack.
• Hyperthyroidism.
• Hypoglycemia (low blood sugar).
• Imbalanced electrolytes.

A note from Cleveland Clinic

Premature ventricular contractions are a type of irregular heartbeat. They occur when the electrical signal that starts your heartbeat comes from your lower heart chambers instead of your top heart chamber. A PVC often feels like a skipped heartbeat or heart flutter. However, most people experience no symptoms at all. PVCs aren’t dangerous in most people. Your risk of PVC complications increases if you have other health conditions, including heart disease.