Premature Ventricular Contractions (cont.)
What are the treatments for premature ventricular contractions?
The reasons for treating premature ventricular
contractions are:
- to relieve symptoms of palpitation;
- to treat conditions
that cause premature ventricular contractions since many conditions that cause
premature ventricular contractions are potentially life
threatening; and
- to prevent ventricular tachycardia and sudden death.
In
healthy individuals without heart disease, premature ventricular contractions need no treatment. For relief
of palpitations, one may consider the following measures:
- stop alcohol and caffeine intake;
- stop over-the-counter
nasal decongestants that may contain
adrenaline such as
medications containing pseudoephedrine (certain weight loss supplements may aggravate
premature ventricular contractions, and should never be used without consulting with one's physician);
- stop drug abuse such as amphetamines, cocaine;
and
- stop cigarette
smoking.
Conditions that can cause premature ventricular contractions can also be
potentiality life-threatening. These conditions are often treated in hospital-monitored beds. Monitored beds are beds (or rooms) that are equipped to
record the patients' heart rhythm continuously. Patients are also given
intravenous medications. These conditions are:
- low potassium or magnesium
levels (hypokalemia and hypomagnesemia) - potassium and magnesium can be
given intravenously;
- digoxin and aminophylline toxicity: medications can be given to counteract drug toxicity;
- acute heart attack: medications and procedures (coronary angiogram and
PTCA) are performed urgently to open blocked coronary arteries to
restore blood supply to the heart muscle; and
- low blood oxygen levels (hypoxia): oxygen can be given
nasally, and medications can be given to treat the underlying lung diseases.
Anti-arrhythmia medications
Anti-arrhythmia medications are used to control premature ventricular
contractions with the goal of
preventing ventricular tachycardias, ventricular fibrillations, and
sudden
death. Examples of anti-arrhythmia medications include beta-blockers,
procainamide (Pronestyl, Procan-SR, Procanbid),
amiodarone (Cordarone), and several others.
Unfortunately, there is little scientific evidence that suppressing premature
ventricular contractions with
anti-arrhythmic medications prevent ventricular tachycardias, ventricular
fibrillations, and sudden death.
Some anti-arrhythmia medications actually can
cause abnormal heart rhythms. Thus anti-arrhythmic medications are only
prescribed cautiously in patients at high risk of developing ventricular
tachycardia and ventricular fibrillation; and usually initially in the hospital setting. This does not apply to beta-blockers, which are prescribed to many heart patients for many reasons, and not only do not accelerate arrhythmias, but usually decrease
premature ventricular contractions.
In many patients with premature ventricular contractions and significant underlying cardiac disease, or with severe symptoms, electrophysiology testing (EP) may be recommended. This is a test
performed with catheters to see if a patient is at risk of life-threatening ventricular arrhythmias, which are treated with either medications or sometimes tiny implantable defibrillators.
Last Editorial Review: 10/29/2009
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