Ventricular Ectopic Beats

A ventricular ectopic beat (VEB) is an extra heartbeat originating in the lower chamber of the heart. This beat, also called a premature ventricular contraction (PVC), occurs before the beat triggered by the heart's normal function.

Description

Ventricular ectopic beats are common and do not indicate a problem in people without heart disease. However, if a person has aortic stenosis, heart failure, or a previous heart attack, VEBs may be followed by ventricular tachycardia and fibrillation, which can lead to sudden death.

Causes and symptoms

Although the origin of a VEB is well documented, the exact cause or causes are not well understood. Some physicians believe the beat is caused by a trigger of specific origin, while other physicians believe the beat is random. Occasional ventricular ectopic beats occur in healthy people. If there is no evidence of heart disease, there is little or no danger to the individual.

A single ventricular ectopic beat has very little effect on the pumping ability of the heart and usually does not cause any symptoms. If a symptom is felt, it is the feeling of a strong or skipped beat, often described as a thump, kick, or flip-flop. Sometimes, the sensation is referred to as a fullness in the neck.

Diagnosis

Ventricular ectopic beats are easily seen on an electrocardiogram.

Treatment

If a person is otherwise healthy, the only treatment needed is to decrease stress and limit the use of alcohol and caffeine. Cold medicines, available without prescription, sometimes contain drugs (e.g., decongestants) that stimulate the heart and should be used with caution.

If symptoms are uncomfortable, or the pattern of VEBs indicates a problem, the physician may prescribe drug therapy. Beta-blockers are quite safe and are usually tried first.

A person who has a history of heart attack or heart disease, and is experiencing frequent or complex VEBs, is at greater risk of sudden death. Drug therapy with beta-blockers will be recommended. In addition, angioplasty or coronary artery bypass surgery may relieve any underlying coronary artery blockage and reduce the danger of sudden death.

Treatment with antiarrhythmic drugs can suppress VEBs, but they can also increase the risk of a fatal abnormal rhythm. Often, extensive electrophysiologic testing and risk evaluation will be done before this method of treatment is prescribed.

Prognosis

In healthy people, VEBs are inconsequential. If the person with heart disease is able to find an effective means of controlling ventricular ectopic beats, the out-look is good.

Prevention

Occasional ventricular ectopic beats in healthy people do not need to be prevented. People with a history of heart disease can usually control VEBs with medication.