Approach to Management of Premature Ventricular Contractions.

PURPOSE OF REVIEW: Premature ventricular contractions (PVCs) are arrhythmias with presentation ranging from asymptomatic and benign to symptomatic, frequent and capable of inducing cardiomyopathy. Work in the late 1970s-1980s showed that they could be representative of underlying coronary artery disease, hypertension, or left ventricular hypertrophy. Furthermore, their presence is independently linked to an increased risk of stroke and sudden cardiac death. Since characterization of PVC-induced cardiomyopathy 21 years ago, there has been progressive interest in treating PVCs. This review aims to present an approach that practitioners can use for the treatment of PVCs.

RECENT FINDINGS: Recent efforts have focused on optimizing techniques for mapping and ablation of PVCs in patients with symptoms or reduced LVEF. However, an understanding of the medical treatment options is necessary because medical management is still the first line of therapy. The practitioner will need to weigh the risks and benefits of these strategies in order to help the patient determine the best course of action. PVCs are recognized as a clinically significant arrhythmia, and evolving treatment strategies can improve cardiovascular outcomes. This review provides a concise summary of the current state of PVC treatment.