What Are Premature Ventricular Contractions?
A heart is made of four chambers, with two chambers on the top and the other two chambers below. The upper chambers are the right and left atrium, and the lower chambers are the right and left ventricles. The upper chambers receive the incoming blood, and the lower chambers are responsible for pumping the blood out of the heart. Usually, the upper chambers contract first, and then shortly after, the ventricles contract.
But in specific scenarios, the ventricles contract before the right and left atria contract in a cardiac cycle, which gives rise to a condition known as premature ventricular contractions. Pacemaker cells are specialized cells above the heart’s upper chamber, which act like a battery and send electrical signals that help the heart beat in a regular rhythm. However, premature ventricular contractions occur because of an abnormal ventricle contraction signal rather than pacemaker cells.
What Are the Other Names for Premature Ventricular Contractions?
They are known by several other names like:
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Premature ventricular complexes.
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Ventricular extrasystoles.
Are Men and Women Equally Affected?
Studies have shown that men are affected more than women.
What Causes Premature Ventricular Contractions?
In most cases, there is no significant cause, and it happens spontaneously. But there can be several factors that can trigger a premature ventricular contraction. A few elements are:
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Electrolyte Imbalance: It acts like a stressor that enhances the automaticity of the heart.
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Increased Adrenaline: This can happen due to anxiety, stress, consumption of caffeine, or excess exercise.
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Medications: The consumption of decongestants, antihistamines, and other drugs like Cocaine and Methamphetamines.
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Heart Diseases: For example, heart attack, congenital heart disease, and coronary artery disease. They can lead to injury to the cardiac muscles and their associated structures.
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Alcohol and Tobacco Abuse: They act as stimulants that can trigger a premature ventricular contraction.
Which Individuals Have a Higher Risk of Developing Premature Ventricular Contractions?
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Elderly individuals.
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Individuals with prior history of heart disease (for example, bundle branch block, ischemic heart disease, etc).
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Individuals with hypertension (high blood pressure) and diabetes (high blood glucose).
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Individuals who are diagnosed with hypomagnesemia (an electrolyte imbalance disorder caused due to low-level of magnesium in the blood).
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Males.
What Are the Symptoms of Premature Ventricular Contractions?
Most individuals do not elicit any symptoms and remain undiagnosed. Symptoms usually arise if an underlying disease triggers premature ventricular contractions. A few of the symptoms produced by abnormal heartbeats originating from the ventricles are as follows:
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Dizziness or lightheadedness due to decreased blood flow to the brain.
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A feeling of fluttering in the chest with increased awareness of heartbeats.
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Increased palpitations (rapid, strong heartbeats, which are irregular).
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Increased anxiety.
How Does a Doctor Identify Premature Ventricular Contractions?
A physician would advise the following tests to confirm and diagnose an individual with premature ventricular contractions:
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Blood Panel: To help assess the electrolyte levels to rule out electrolyte imbalance. Specific electrolyte tests include tests for levels of potassium, magnesium, and calcium.
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Electrocardiogram (ECG or EKG): It monitors the electrical signals from the heart and utilizes several electrodes. Electrodes are small sensors (in the form of stickers) that are attached to the body. It evaluates irregular electrical signals and helps identify the source of malfunction. Electrocardiography may not be an efficient test for those individuals who do not have premature ventricular contractions very often. In such individuals, the heartbeats are monitored using portable electrocardiogram devices, such as the Holter’s monitor or an event monitor. A Holter monitor is used for a day or more, whereas an event monitor is worn for at least 30 days.
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Stress Test: A test that analyzes the heart response during an intense level of activity. It is done with the help of an EKG (electrocardiograph) machine and a treadmill or stationary bike.
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Holter Monitor: It is essentially an ECG (electrocardiograph) but in the form of a portable device. The person wears this device while the individual performs their daily activities, monitoring the heartbeats throughout the day. Since certain arrhythmias (also known as irregular heartbeats) occur at different times of the day depending on their trigger or cause, a Holter monitor helps identify the trigger by constantly monitoring the electrical signals of the heart for 24 hours or more.
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Event Monitor: It is also a portable ECG (electrocardiogram) but is worn for a longer duration at least 30 days or up until the subsequent arrhythmia or irregular heartbeat is recorded.
What Are the Complications Associated With Premature Ventricular Contractions?
Heart diseases accompanying premature ventricular contractions can trigger ventricular tachycardia or ventricular fibrillation. They both are serious and intense arrhythmias. If they occur for months or years, they can lead to cardiomyopathy or heart muscle weakening. Less accumulation of blood means less blood and oxygen being transported to different body parts.
How to Manage Premature Ventricular Contractions?
In most cases, there is no intervention required. However, if there are any obvious triggers, for example, medication or substance abuse, then stopping typically resolves the issue. Premature ventricular contractions can be managed in the following ways:
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Lifestyle Modifications: Occasional premature ventricular contractions can be managed by identifying the particular trigger and actively eliminating them. Studies show a strong correlation between larger intakes of carbohydrates and sugars with premature ventricular contractions. Hence, making dietary modifications by limiting their intake can help prevent triggering premature ventricular contractions. Along with modified dietary intake, increasing physical activity also helps improve heart health.
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Medication: Chronic or recurring premature ventricular contractions need medications which include beta-blockers and calcium channel blockers. They help prevent the heart from beating too strongly. A few examples of beta-blockers include - Atenolol and Propranolol. A few examples of calcium channel blockers include Amlodipine and Nifedipine.
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Radiofrequency Catheter Ablation: It is a technique used in patients whose medications fail to show results or cause side effects. It involves using radio-frequency waves to cauterize and destroy the cells responsible for premature ventricular contractions and abnormal cardiac function. Studies show that radiofrequency catheter ablation has remarkable success rates in suppressing premature ventricular contractions.
Conclusion:
Generally, patients with premature ventricular contractions have a good prognosis. Making good lifestyle modifications and getting routine body check-ups helps with early diagnosis and prevents further complications. Patients with other underlying diseases that make them vulnerable to premature ventricular contractions should get a thorough medical check-up and follow their physician’s advice.
