VENTRICULAR ECTOPICS

Clinical features

Extra-beats

Missed beats

Causes

• Anxiety
• Beta-agonists
• Excess caffeine
• Hypokalaemia
• Digoxin toxicity

ECG

Broad and bizarre QRS complex.

Management

In a normal heart, they may be found in normal people often prominent at rest and disappear with exercise. No treatment is required; just a beta-blocker may be given to reduce palpitation and anxiety.

In myocardial infarction frequent PVCs are observed but they are of no prognostic value and require no treatment. However persistent frequent PVCs (> 1 0/h) indicate a poor long-term outcome. Antiarrhythmic therapy does not improve prognosis.

In heart failure also PVCs are common but suppression with antiarrhythmic drugs does not improve the prognosis; just treatment of heart failure may suppress these ectopic beats.