Ventricular Ectopic Beats

Ventricular Ectopic Beats

 

Definition

A ventricular ectopic beat (VEB) is an extra heart-beat 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 outlook 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.

Resources

Organizations

American Heart Association. 7320 Greenville Ave. Dallas, TX 75231. (214) 373-6300. http://www.americanheart.org.

Key terms

Angioplasty — A surgical procedure which dilates a narrowed or blocked part of an artery.
Aortic stenosis — A stiffening of the artery which carries blood from the heart to the body.
Beta-blockers — A class of medication used to block the cellular response to chemicals normally present in the body.
Coronary artery — The vessel which brings blood to the muscle of the heart.
Fibrillation — Rapid, uncoordinated quivering of the heart.
Heart failure — A term used when the heart is unable to pump enough blood to supply the needs of the body.
References in periodicals archive ?
24 hour ECG Holter monitoring has shown stable sinus rhythm with an average of 67 beats per minute (minimum of 60 beats per minute and maximum 87 beats per minute), diffuse variable ST segment depressions and negative T waves, rare and isolated supraventricular and ventricular ectopic beats, with uniform distribution between active and passive periods.
6) showed a strong correlation between ventricular ectopic beats and total mortality and sudden death in 183 patients with SSc.
Normal adaptations found on a 12-lead electrocardiogram (ECG) of a pregnant patient Left axis deviation of the heart (the heart is rotated to the left in normal pregnancy) Transient ST-segment and T-wave changes (inverted T wave) Atrial ectopic beats Ventricular ectopic beats Table 3.
VT episodes were evaluated by demonstrating three or more rapid consecutive ventricular ectopic beats in either a 24-h ambulatory ECG or a 12-h lead ECG (see below), assessed during either outpatient clinical or in-hospital admission as a consequence of an adverse event.
Carbachol infusion induced preconditioning with a marked depression of mean arterial blood pressure, heart rate and the total number of ventricular ectopic beats.
In that study, more than two ventricular ectopic beats on a recording upon admission to the hospital predicted fatal outcome with 100% sensitivity and cent percent specificity.
Phase I, or the early phase, is typically silent, can feature sporadic ventricular ectopic beats, subtle ECG changes, morphologic abnormalities, and sudden death.
VT was defined as three or more consecutive, ventricular ectopic beats at a rate of more than 120 beats per minute.
The weight loss effects of sibutramine must be balanced against the cost of the drug ($108 per month) and possible adverse health effects (increased heart rates, ventricular ectopic beats, or epileptic seizures).
Electrocardiographic recordings were initially scanned at high speed and subsequently reviewed for more precise analysis by two observers, with the total number of ventricular ectopic beats being determined for each subject.

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