PVCs in patients with structural heart disease such as LVH, cardiomyopathy, and congestive heart failure, prior myocardial infarction, etc. įrom a clinical perspective it is useful to divide patients with frequent PVCs into those with and those without structural heart disease: Additional diagnostic tests (Nuclear perfusion study, cardiac catheterization, cardiac MRI, etc) should be based on the individual clinical scenario.

Once PVCs are documented it is often useful to proceed with an echocardiogram to evaluate for underlying structural heart disease and exercise stress testing to assess the impact of physical activity on PVCs. There have been some reports of frequent PVCs resulting in a “tachycardia induced” cardiomyopathy, which can be reversed with successful elimination of PVCs by catheter ablation (ref 1).Įvent monitoring is highly effective in correlating a patient's symptoms to presence or absence of arrhythmias, and such correlation should form the basis for invasive therapies. Patients with a high frequency of PVC (> 20-40% of all beats) may require more aggressive therapy independent of symptoms. Holter monitoring can help correlate PVCs to symptoms and is a suitable tool to quantify PVC frequency (which may have an important impact with regard to clinical management). LVH, Q-waves in patients with prior myocardial infarction). In addition, the 12-lead EKG can be used to assess whether PVCs are monomorphic/monotopic (suggesting a single site of arrhythmia origin) and whether one should look for possible structural heart disease (i.e. The 12-lead EKG is very useful in identifying the PVC morphology, as certain clinical syndromes exhibit very characteristic PVC morphologies (see below). While patients may be asymptomatic, typically these PVCs cause sensations of skipping, heart pounding, and possibly chest pain, shortness of breath or dizziness. Premature ventricular complexes, or PVCs, are a common clinical problem. Clinical Approach to Patients with Frequent PVCs

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