Premature Ventricular Contractions (cont.)

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What are the treatments for premature ventricular contractions?

The reasons for treating premature ventricular contractions are:

  1. to relieve symptoms of palpitations;
  2. to treat conditions that cause premature ventricular contractions since many conditions that cause premature ventricular contractions are potentially life threatening; and
  3. 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 the use of over-the-counter (OTC) 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.

Antiarrhythmia medications

Antiarrhythmia medications are used to control premature ventricular contractions with the goal of preventing ventricular tachycardias, ventricular fibrillations, and sudden death. Examples of antiarrhythmia medications include beta-blockers amiodarone (Cordarone) and several others. Unfortunately, there is little scientific evidence that suppressing premature ventricular contractions with antiarrhythmic medications prevents ventricular tachycardias, ventricular fibrillations, and sudden death.

Some antiarrhythmia medications actually can cause abnormal heart rhythms. Thus antiarrhythmic 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.

REFERENCES:

"Sudden Cardiac Arrest." Cleveland Clinic. March 2010.

Simpson, R. J. Jr., et al. "Prevalence of premature ventricular contractions in a population of African American and white men and women: the Atherosclerosis Risk in Communities (ARIC) study." American Heart Journal 143.3 (2002): 535-540.

Zipes, Douglas P. and Hein J. J. Wellens. "Sudden cardiac death." Circulation 98.21 (1998): 2334-2351.

Medically reviewed by Robert J. Bryg, board certified in internal medicine with a subspecialty in cardiovascular disease.


Medically Reviewed by a Doctor on 11/13/2013

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