Premature Ventricular Complexes and Premature Ventricular Complex Induced Cardiomyopathy

Curr Probl Cardiol. 2015 Sep;40(9):379-422. doi: 10.1016/j.cpcardiol.2015.03.002. Epub 2015 Mar 5.

Abstract

Presentation, prognosis, and management of premature ventricular complexes (PVCs) vary significantly among patients and depend on PVC characteristics as well as patient comorbidities. Presentation can range from incidental discovery in an asymptomatic patient to debilitating heart failure. Prognosis depends on, among other factors, the presence or absence of structural heart disease, PVC burden and other factors detailed in this review. Our understanding of the clinical significance of frequent PVCs, particularly as it relates to development of cardiomyopathy, has advanced greatly in the past decade. In this article, we explore the mechanisms governing PVC initiation and discuss prevalence and frequency of PVCs in the general population. We also explore prognostic implications based on PVC frequency as well as the presence or absence of underlying heart disease. We then take a focused look at PVC-induced cardiomyopathy and identify predictors for developing cardiomyopathy. Finally, we discuss clinical evaluation and management of patients presenting with frequent PVCs. Management can include clinical observation, addressing reversible causes, lifestyle modification, pharmacotherapy, or catheter ablation.

Publication types

  • Review

MeSH terms

  • Anti-Arrhythmia Agents / therapeutic use
  • Cardiac Pacing, Artificial
  • Cardiomyopathies / etiology*
  • Cardiomyopathies / therapy*
  • Catheter Ablation
  • Death, Sudden, Cardiac / etiology
  • Echocardiography
  • Electrocardiography
  • Heart Diseases
  • Humans
  • Prevalence
  • Prognosis
  • Recovery of Function
  • Risk
  • Ventricular Premature Complexes / complications*
  • Ventricular Premature Complexes / diagnosis
  • Ventricular Premature Complexes / therapy*

Substances

  • Anti-Arrhythmia Agents