If you’ve ever felt your heart flutter or skip a beat, you’ve likely experienced premature ventricular contractions, or PVCs. PVCs are extra heartbeats that come from the lower chambers of your heart and disrupt your heart’s normal rhythm.
It’s a common condition that can be experienced by people of all ages. Often, it’s not a sign of a serious problem. But sometimes it is.
“Heart disease is the most common cause, but there are several causes that can trigger the extra heartbeat,” said Dr. Sameer Chaudhari, a cardiologist at Novant Health Heart & Vascular Institute in Monroe, North Carolina. “The other most common causes we see are emotional, physical and mental stress on the body; excess of caffeine; excess of alcohol; dehydration and lack of adequate electrolytes in the diet such as potassium and magnesium.”
Occasional PVCs are commonly experienced by people of all ages. Actually, Chaudhari said, “The patients who experience the most symptoms associated with PVCs are in the younger group, like in their 20s, 30s and sometimes 40s. Those are usually connected to those lifestyle causes.”
If you regularly start to notice the occurrence of PVCs, it can be alarming. Here’s what you should know.
Get your PVCs checked out by a cardiologist if they’re happening frequently.
“Some people feel it a few times a week, some people feel it several times a day,” Chaudhari said. “Normally we can ignore it if it’s just happening a few times a week, but if it’s happening every day, then we definitely want you to come in and get checked out.”
Why: While PVCs are a benign condition and don’t harm the body directly, they either can point to heart disease or, over time, a high frequency of untreated PVCs could cause a weakening of the heart muscle.
Get your PVCs checked if they’re causing additional symptoms beyond a heart flutter or palpitation.
“The most common symptom is palpitation, either skipping of heartbeat or racing of heartbeat,” Chaudhari said. “Other symptoms are light-headedness, feeling like you’re going to pass out, dizziness. Very rarely, people can actually pass out if the PVCs last for several beats in a row.”
You’ll talk through your medical history and lifestyle when you see a cardiologist for PVCs.
Your initial consultation with a cardiologist will start with patient history, potentially followed by tests. Patient history will cover how long, how frequently and how intensely you’ve been experiencing symptoms of PVCs, as well as whether you have a family history of heart disease.
“The No. 2 factor is lifestyle,” Chaudhari said. “We ask about stress level, caffeine and alcohol intake, medications, etc.”
Your doctor will also check for a heart murmur and high blood pressure.
There are 3 tests included in a basic workup for PVCs: an electrocardiogram, a heart monitor and an echocardiogram.
The electrocardiogram (also called an ECG or EKG) is a quick test using electrodes on the chest that can be done in the office. The EKG checks heart signals to determine if there are heart conditions like poor blood flow, heart attack or abnormalities like a thickened heart muscle.
You might also get sent home wearing a heart monitor, which often comes in the form of a small patch that easily attaches to your chest to record your heart rhythm. Depending on the frequency of your symptoms, you might wear a monitor for one to three days (if your symptoms are daily), or seven to 30 days (if your symptoms are weekly).
Then, you may be scheduled for an echocardiogram, an ultrasound of the heart. “This is to see if the patient’s heart-pumping power is normal or not,” Chaudhari said.
How to adjust your lifestyle to try to help reduce the frequency of PVCs.
The good news: If you’re a generally healthy person and aren’t presenting signs of heart disease or other heart conditions, you have a good shot at tweaking your lifestyle to reduce or eliminate your PVCs.
As Chaudhari mentioned, stress and anxiety can be a big factor in causing PVCs. “With anxiety and PVCs, it’s a vicious cycle,” he said. “Anxious people get more PVCs and PVCs make them more anxious.”
Your doctor may work with you to determine the root cause of your stress, whether you have anxiety that could benefit from medication or whether there’s stress that you could work on addressing.
If stress doesn’t seem to be a factor, Chaudhari said, the patient can try minimizing caffeine and alcohol intake. Or, if blood work indicates low mineral amounts like potassium and magnesium, a supplement may be recommended.
If lifestyle changes aren’t working, medication may be prescribed.
“We prefer to not put a person on medication directly, unless there’s a strong reason for it,” Chaudhari said. “After trying all the lifestyle factors and ruling out structural heart disease, high blood pressure, congestive heart failure or any reversible factors, we start out with a low-dose beta blocker or low-dose calcium-channel blocker.”
These are technically blood pressure medicines, but they can also help reduce PVCs.
“Most of the time, once a patient starts medicine, they report an improvement in quality of life,” Chaudhari said. “If within four weeks a patient says symptoms are partially better or not better at all, then we check with a heart monitor again to see if the medicines have had a good effect.”
Certain medications are actually designed to suppress extra heartbeats, and could become an option.
If medications don’t help alleviate PVCs, ablation can be an option.
An ablation is a procedure that targets the tissue in the heart where the PVCs are originating. That area of tissue is essentially killed off so it won’t activate and continue to interrupt the heart’s natural rhythm.
“It can decrease the frequency of PVCs or provide complete resolution of PVCs,” Chaudhari said. “It’s very low-risk, pretty high-success rate. There’s a less than 1% chance of complication.”
Even if you don’t need to treat PVCs, it’s helpful to have this diagnosis in your medical chart.
Patients tend to have a higher amount of PVCs during events like a procedure, so it’s beneficial for your other providers to have all of that information. Luckily, PVCs generally don’t cause issues during procedures, Chaudhari said.
And for patients with no heart disease or abnormalities, it’s likely PVCs will resolve over time without treatment. “Very rarely is it a lifelong phenomenon,” Chaudhari said. “Most patients in the younger age group come out of PVCs as stress levels go down or as they change their lifestyles.”
