Premature Ventricular Contractions (PVCs) - Treatment

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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.

Return to Premature Ventricular Contractions (PVCs)

See what others are saying

Comment from: jabara77, 55-64 Male (Patient) Published: April 16

I have premature ventricular contractions (PVCs) since 35 years ago due to stress when I was a student at college of engineering. At that time my cardiologist saw my heart was healthy and sent me to a psychiatrist. I use Ativan and see it stops PVCs but I still have palpitation, now I use citalopram but I have PVCs within controlled limit.

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Comment from: Ccbeme, 35-44 Female (Patient) Published: December 06

When my PVCs are really bothersome, it's often due to dehydration. I find that drinking plenty of water, drinking a fruit smoothie, and taking a multivitamin really help. My cardiologist has always encouraged me to stay active, and I do, though I need to watch out for dehydration. He did prescribe a beta blocker, but I find that taking in lots of non-caffeinated fluids and getting enough potassium in my diet helps even more.

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