Premature ventricular contractions

Last updated: April 20, 2023

Summarytoggle arrow icon

Premature ventricular contractions (PVCs) are extra, abnormal heartbeats caused by ectopic foci within the ventricles. PVCs are very common and most individuals are asymptomatic, but select patients may present with symptoms such as dizziness or palpitations. Typical ECG findings of PVCs include broad QRS complexes, compensatory pauses, and axis deviation, and may be random or have consistent patterns, such as couplets or bigeminy. Most patients do not require treatment. However, any underlying condition, e.g., myocarditis, must be managed appropriately. Patients with frequent PVCs that cause significant symptoms should receive antiarrhythmic drugs or possibly catheter ablation, as they are at risk for sudden cardiac death.

Etiologytoggle arrow icon

Pathophysiologytoggle arrow icon

Classificationtoggle arrow icon

  • Monomorphic PVC: Each PVC has the same configuration, i.e., identical origin
  • Polymorphic PVC: PVCs have different configurations, i.e., multiple foci

Clinical featurestoggle arrow icon

Diagnosticstoggle arrow icon


ECG findings

  • Common characteristics
  • Possible additional characteristics
    • Single PVC
    • Couplet: two PVCs in a row
    • Triplet: three PVCs in a row
    • Bigeminy: one extrasystole after every single sinus beat
    • Trigeminy: one extrasystole after every two sinus beats

PVCs are a common incidental finding on routine ECGs. The detection of them does not require any further workup in patients who are asymptomatic.

Additional procedures

Treatmenttoggle arrow icon

  • Most patients do not require any treatment
  • Treat any underlying disease (e.g., CAD, myocarditis)
  • Only treat frequent and significantly symptomatic PVCs

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 Evidence-based content, created and peer-reviewed by physicians. Read the disclaimer