What are ventricular premature beats?

A ventricular premature beat (VPB) is an abnormal, extra heartbeat. Almost everyone has VPBs at some time. They are more likely as you get older.

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

VPBs may also be called premature ventricular contractions or ventricular premature contractions.

What is the cause?

An electrical signal in your heart starts each heartbeat, causing the heart muscle to squeeze (contract). Normally, this signal starts in the upper right chamber of the heart (the right atrium) at a place called the sinus node. The signal then follows pathways to the upper left atrium and to the lower chambers of the heart (the ventricles). A VPB starts from one of the lower heart chambers instead of the right atrium. This may happen if you:

• Have a scar in the heart muscle from an earlier injury or surgery
• Have too little oxygen getting to your heart because of heart disease
• Take medicines, such as stimulants, diet pills, or decongestants
• Take in too much caffeine or alcohol
• Use amphetamines or cocaine
• Are under stress
• Receive a blow to the chest
• Have low levels of potassium or magnesium in your blood

Often the cause of VPBs is not known. VPBs can happen even though you have a healthy heart.

What are the symptoms?

You may not be aware of VPBs. Or you may notice “flip-flops” or skipped beats with an odd feeling in your chest. They may happen rarely or often.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you.

You will have an ECG (also called an EKG or electrocardiogram), which measures and records your heartbeat. You may have an ECG while you are resting or while you exercise on a treadmill. You may also be asked to wear a small portable ECG monitor for a few days or longer.

To help diagnose the cause of VPBs, you may have an echocardiogram, which uses sound waves (ultrasound) to see how well your heart is pumping.

How is it treated?

If you have a healthy heart, VPBs are generally not dangerous and don’t need treatment. Making changes in your lifestyle or diet, drinking less alcohol or caffeine, and knowing that the VPBs are not dangerous may help reduce anxiety and decrease how often you have them.

If VPBs cause severe symptoms, treatment may include:

• Medicine to slow your heartbeat
• Ablation, which uses a small tube called a catheter to deliver electrical pulses to the inside of the heart. The electrical pulses make small scars that block abnormal electrical pathways. This helps you have a regular heart rhythm.
• An implantable cardiac defibrillator (ICD), which is a device that can shock the heart back to a regular rhythm.

How can I take care of myself?

If you have heart disease, high blood pressure or another medical problem, follow your treatment plan. Be sure to take all medicines as prescribed by your healthcare provider.

Try to have a heart-healthy lifestyle:

• Eat a healthy diet.
• Limit caffeine
• Try to keep a healthy weight. If you are overweight, lose weight.
• Stay fit with the right kind of exercise for you.
• Learn ways to manage stress.
• Try to get at least 7 to 9 hours of sleep each night. If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
• If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Although an occasional alcoholic or caffeinated drink is usually OK, you may find that too much alcohol or caffeine can trigger symptoms. If so, you may need to avoid alcohol or caffeine.

Ask your provider:

• How and when you will hear your test results
• How long it will take to recover
• What activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent ventricular premature beats?

There is no specific way to prevent ventricular premature beats, but a healthy lifestyle can help prevent heart disease, which can cause VPBs.