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Premature ventricular contractions (PVCs) are extra heartbeats that begin in one of the heart's two lower pumping chambers (ventricles). These extra beats disrupt the regular heart rhythm, sometimes causing a sensation of a fluttering or a skipped beat in the chest.
Premature ventricular contractions are a common type of irregular heartbeat (arrhythmia). PVCs are also called:
Occasional premature ventricular contractions in people without heart disease usually aren't a concern and likely don't need treatment. You might need treatment if the premature ventricular contractions are very frequent or bothersome, or if you have an underlying heart condition.
Premature ventricular contractions often cause few or no symptoms. But the extra beats can cause unusual sensations in the chest, such as:
If you feel fluttering, pounding or a sensation of skipped heartbeats in your chest, talk to your health care provider. A health care provider can determine if the sensations are due to a heart condition or other health concern. Similar signs and symptoms can be caused by many other conditions such as anxiety, low red blood cell count (anemia), overactive thyroid (hyperthyroidism) and infections.
To understand the cause of premature ventricular contractions (PVCs), it might help to learn more about how the heart typically beats.
The heart is made of four chambers — two upper chambers (atria) and two lower chambers (ventricles).
The heart's rhythm is controlled by a natural pacemaker (the sinus node) in the right upper chamber (atrium). The sinus node sends electrical signals that typically start each heartbeat. These electrical signals move across the atria, causing the heart muscles to squeeze (contract) and pump blood into the ventricles.
Next, the signals arrive at a cluster of cells called the AV node, where they slow down. This slight delay allows the ventricles to fill with blood. When the electrical signals reach the ventricles, the chambers contract and pump blood to the lungs or to the rest of the body.
In a typical heart, this heart signaling process usually goes smoothly, resulting in a resting heart rate of 60 to 100 beats a minute.
PVCs are irregular contractions that start in the ventricles instead of the atria. The contractions usually beat sooner than the next expected heartbeat.
The cause of premature ventricular contractions isn't always clear. Certain things including heart diseases or changes in the body can make cells in the lower heart chambers electrically unstable. Heart disease or scarring may cause the heart's signals to be misrouted.
Premature ventricular contractions may be caused by:
Certain lifestyle choices and health conditions may make a person more likely to develop premature ventricular contractions (PVCs).
Risk factors for PVCs include:
Having frequent premature ventricular contractions (PVCs) or certain patterns of them might increase the risk of developing irregular heart rhythms (arrhythmias) or weakening of the heart muscle (cardiomyopathy).
Rarely, when accompanied by heart disease, frequent premature contractions can lead to chaotic, dangerous heart rhythms and possibly sudden cardiac death.
To diagnose premature ventricular contractions (PVCs), a health care provider will typically listen to your heart with a stethoscope. You may be asked questions about your lifestyle habits and medical history.
Tests are done to confirm a diagnosis of premature ventricular contractions.
An electrocardiogram (ECG or EKG) can detect the extra beats and identify the pattern and source.
An ECG is a quick and painless test to record the heart's electrical activity. Sticky patches (electrodes) are placed on the chest and sometimes the arms and legs. Wires connect the electrodes to a computer, which displays the test results. An ECG can show if the heart is beating too fast, too slow or not at all.
If you don't have PVCs very often, a standard ECG may not detect them. Your health care provider may ask you to use a portable ECG device at home to obtain more information about your heartbeats. Portable ECG devices include:
Your health care provider may also recommend an exercise stress test. This test often involves walking on a treadmill or riding a stationary bike while an ECG is done. An exercise stress test can help determine whether exercise triggers your PVCs.
Most people with premature ventricular contractions (PVCs) who don't have heart disease won't need treatment. If you have heart disease, PVCs can lead to more-serious heart rhythm problems (arrhythmias). Treatment depends on the underlying cause.
A health care provider may recommend the following treatment for frequent PVCs:
The following self-care strategies can help control premature ventricular contractions (PVCs) and improve heart health:
You're likely to start by seeing your family care provider. You may be referred to a doctor trained in heart diseases (cardiologist).
Here's some information to help you get ready for your appointment.
Make a list of:
Take a friend or relative with you, if possible, to help you remember the information you receive.
For premature ventricular contractions, questions to ask your health care provider include:
Don't hesitate to ask other questions.
Your health care provider is likely to ask you questions, including: