Overview
What is a premature ventricular contraction (PVC)?
What is the pathophysiology of premature ventricular contractions (PVCs)?
Which factors increase the risk of premature ventricular contractions (PVCs)?
What are the cardiac causes of premature ventricular contractions (PVCs)?
What are noncardiac causes of premature ventricular contractions (PVCs)?
What is the prevalence of premature ventricular contractions (PVCs) in the US?
What are the demographics of premature ventricular contractions (PVCs)?
What is the mortality and morbidity of premature ventricular contractions (PVCs)?
Presentation
Which features of the patient history are relevant in premature ventricular contractions (PVCs)?
Which symptoms are pertinent to the management of premature ventricular contractions (PVCs)?
DDX
What are the differential diagnoses for Premature Ventricular Contraction?
Workup
Which lab studies are indicated in the workup of premature ventricular contractions (PVCs)?
What is the role of echocardiography in the workup of premature ventricular contractions (PVCs)?
What is the role of ECG in the workup of premature ventricular contractions (PVCs)?
What is the Lown system for grading premature beats in premature ventricular contractions (PVCs)?
What is the role of signal-averaged ECG in the workup of premature ventricular contractions (PVCs)?
Treatment
When is treatment indicated for premature ventricular contractions (PVCs)?
What are the prehospital procedures for patients with premature ventricular contractions (PVCs)?
What is the role of catheter ablation in the treatment of premature ventricular contractions (PVCs)?
Medications
Which medications are used in the treatment of premature ventricular contractions (PVCs)?
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ECG shows frequent, unifocal PVCs with a fixed coupling interval between the ectopic beat and the previous beat. These PVCs result in a fully compensatory pause; the interval between the 2 sinus beats surrounding the PVC are exactly twice the normal R-R interval. This finding indicates that the sinus node continues to pace at its normal rhythm despite the PVC, which fails to reset the sinus node.
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On this ECG, the PVCs occur near the peak of the T wave of the preceding beat. These beats predispose the patient to ventricular tachycardia or fibrillation. This R-on-T pattern is often seen in patients with acute myocardial infarction or long Q-T intervals. In the latter case, the triggered arrhythmia would be torsade.