Ventricular Premature Beats (VPBs)

What are ventricular premature beats (VPBs)?

A normal heartbeat starts from the right upper chamber (atrium) of the heart. A ventricular premature beat (VPB) is an extra heartbeat that starts from one of the lower heart chambers (ventricles). VPBs may also be called premature ventricular contractions or ventricular premature contractions. VPBs occur at some time in almost everyone. They may happen rarely or they may happen often.

VPBs become a medical problem only if you have a weak heart muscle. Frequent VPBs when you have a weak heart muscle increase the risk of sudden death.

How does it occur?

The cause of VPBs is unknown. What is known is that a part of the heart's ventricle muscle becomes electrically unstable and causes the extra heartbeat. The electrical instability can be caused by:

• a scar in the heart muscle
• too little oxygen getting to the muscle due to heart disease
• medicines such as pseudoephedrine
• caffeine or alcohol
• a blow to the chest
• chemical imbalances in the body.

What are the symptoms?

Many people are not aware that they have VPBs. You may be aware of "flip-flops" or skipped beats with an odd feeling in the chest.

How is it diagnosed?

An electrocardiogram is the only test that can confirm a diagnosis of VPBs. An electrocardiogram records the electrical activity of your heart. A 24-hour tape recording of the electrocardiogram shows when and how many VPBs occur. These recordings are often used to help your doctor decide on treatment.

How is it treated?

In people with normal hearts, VPBs are not dangerous and generally do not need treatment. If VPBs cause severe symptoms, you may need to take medicine to control the symptoms. Talk with your healthcare provider about the risks and benefits of treatment. Minor changes in lifestyle or diet, less alcohol, and knowing that the VPBs are not dangerous may help reduce anxiety and decrease the number of VPBs.

If you have frequent VPBs and you also have a weak heart muscle or have had a heart attack, your provider may recommend additional tests, medicines, or an implantable cardioverter-defibrillator (ICD). ICDs detect abnormal heart rhythms and shock the heart back to a normal rhythm.