Epidemiology

PVCs are common among the general population. The estimated prevalence ranges from 1% to 4% on electrocardiogram and 40% to 75% on a 24 or 48-hour Holter monitor.[6] Young and healthy adults have shown a highly similar frequency rate of PVCs in contrast to the older segments of the general population.

PVCs can occur in isolation or in repeated patterns. Two consecutive PVCs are termed doublets while three consecutive PVCs are named triplets. It is important to note that three or more consecutive PVCs are classified as ventricular tachycardia. If the PVCs continuously alternate with a regular sinus beat, the patient is in bigeminy.[3] Likewise, if every third heartbeat is a PVC, then it is named trigeminy.

PVCs present as heart palpitations in most patients. They are usually benign and do not require treatment.

Prognosis

Healthy patients without structural heart disease who experience infrequent PVCs have the same prognosis as the general population. However, those with frequent PVCs (> 1000/day) are at risk of developing dilated cardiomyopathy.[12]

Those experiencing frequent PVCs or symptomatic PVCs should be evaluated to identify the etiology. In many cases, excess intake of stimulants and/or lower levels of potassium and magnesium is the cause of the PVCs. These patients can be easily managed via minimization of stimulants and/or repletion of electrolytes. As well, these management options are viable for those who have asymptomatic and infrequent PVCs but still find them bothersome. Both types of patients also benefit from the minimization of stress.

The medication classes used to treat frequent and/or symptomatic PVCs include antiarrhythmics, beta-blockers, and calcium channel blockers. Commonly used antiarrhythmics include amiodarone and flecainide.