Materiały źródłowe

• #1 Premature ventricular contractions (PVCs) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-ventricular-contractions/diagnosis-treatment/drc-20376762

  To diagnose premature ventricular contractions (PVCs), a health care provider will typically listen to your heart with a stethoscope. You may be asked questions about your lifestyle habits and medical history. […] Tests are done to confirm a diagnosis of premature ventricular contractions. […] An electrocardiogram (ECG or EKG) can detect the extra beats and identify the pattern and source. […] If you don’t have premature ventricular contractions (PVCs) very often, a standard may not detect them. Your health care provider may ask you to use a portable device at home to obtain more information about your heartbeats. […] Your health care provider may also recommend an exercise stress test. This test often involves walking on a treadmill or riding a stationary bike while an is done. An exercise stress test can help determine whether exercise triggers your PVCs. […] For premature ventricular contractions, questions to ask your health care provider include: What tests do I need? […] Don’t hesitate to ask other questions.

• #2 Premature Ventricular Contractions (PVCs)

  https://my.clevelandclinic.org/health/diseases/17381-premature-ventricular-contractions

  Premature ventricular contractions (PVCs) are a type of irregular heartbeat. They occur when the electrical signal to start your heartbeat comes from your lower heart chambers. PVCs are common and usually aren’t dangerous. Your risk of complications increases if you have another heart condition, such as heart disease or a congenital heart defect. […] PVCs usually go away with medication or other minimally invasive treatments. […] PVCs can happen in anyone, but they’re more common in older adults and those with heart disease. […] Your healthcare provider asks you about your symptoms and health history and performs a physical exam. They may listen to your heartbeat with a stethoscope to check for signs of irregularities. […] Usually, the first test is an electrocardiogram (EKG). An EKG measures your heart rate and evaluates the electrical signals in your heart. Your provider usually can see an arrhythmia or extra beats clearly on an EKG.

• #3 Diagnosis and Treatment of Idiopathic Premature Ventricular Contractions: A Stepwise Approach Based on the Site of Origin

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8534438/

  A careful analysis of ECG features can help to predict the SOO and plan the procedure. […] Initial patient evaluation should include detailed clinical history with focus on inherited arrhythmic syndromes, cardiomyopathies and familiar history of SCD, adrenergic substances consumption and metabolic disorders such as hyperthyroidism. […] Beyond the prediction of the SOO, resting ECG may rise the suspicion of underlying SHD in presence of depolarization or repolarization abnormalities including q waves, QRS fragmentation and inverted T waves. […] Exercise stress test should always be part of the initial diagnostic work-up, as exercise-induced PVCs or induction of SVT, as well as frequent PVCs occurring during the recovery phase are all markers of increased risk, even in the absence of myocardial ischemia.

• #4 Diagnosis and Treatment of Idiopathic Premature Ventricular Contractions: A Stepwise Approach Based on the Site of Origin

  https://www.mdpi.com/2075-4418/11/10/1840

  Premature ventricular contractions (PVCs) in the absence of structural heart disease (SHD), or inherited ion channelopathies, are referred to as idiopathic and are among the most common arrhythmias encountered in everyday clinical practice. […] A careful analysis of ECG features can help to predict the SOO and plan the procedure. This review aims to present an overview on the current approach to PVCs, starting from the twelve-lead ECG analysis to clinical manifestations and prognosis, and therapeutic strategies including CA. […] Initial patient evaluation should include detailed clinical history with focus on inherited arrhythmic syndromes, cardiomyopathies and familiar history of SCD, adrenergic substances consumption and metabolic disorders such as hyperthyroidism. […] Beyond the prediction of the SOO, resting ECG may rise the suspicion of underlying SHD in presence of depolarization or repolarization abnormalities including q waves, QRS fragmentation and inverted T waves.

• #5 Premature ventricular contractions (PVCs) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-ventricular-contractions/symptoms-causes/syc-20376757

  Premature ventricular contractions (PVCs) are extra heartbeats that begin in one of the heart’s two lower pumping chambers (ventricles). […] A health care provider can determine if the sensations are due to a heart condition or other health concern. […] The cause of premature ventricular contractions isn’t always clear. […] PVCs are irregular contractions that start in the ventricles instead of the atria. […] Certain lifestyle choices and health conditions may make a person more likely to develop premature ventricular contractions (PVCs). […] Having frequent premature ventricular contractions (PVCs) or certain patterns of them might increase the risk of developing irregular heart rhythms (arrhythmias) or weakening of the heart muscle (cardiomyopathy). […] Rarely, when accompanied by heart disease, frequent premature contractions can lead to chaotic, dangerous heart rhythms and possibly sudden cardiac death.

• #6 Premature Ventricular Contractions (PVCs): Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/heart/arrhythmias/premature-ventricular-contractions-pvcs/treatment

  How are Premature Ventricular Contractions (PVCs) Diagnosed? Diagnosis […] An electrocardiogram (EKG) will be ordered to measure your heart rate, check for electrical impulse deviations, and detect arrhythmia fluctuations in a heartbeat. Some cardiologists require a 24-hour Holter, or longer-term skin patch, monitor to measure the hearts electrical impulses; this device can also detect PVCs. […] Other diagnostic tests may be used to detect PVCs. These tests can confirm the source of the irregularity. Additional tests used to diagnose premature ventricular contractions include: […] Blood tests – These blood tests measure the amount of potassium, magnesium, and thyroid hormone levels. If the levels are compromised, PVCs are possible. […] Cardiac stress test – Your heart rate and blood flow are measured while exercising and at rest

• #7 Premature Ventricular Complex (PVC) • LITFL • ECG Library Diagnosis

  https://litfl.com/premature-ventricular-complex-pvc-ecg-library/

  A premature ventricular complex (PVC) is a premature beat arising from an ectopic focus within the ventricles. PVCs are said to be frequent if there are more than 5 PVCs per minute on the routine ECG, or more than 10-30 per hour during ambulatory monitoring. PVCs may be either: Unifocal arising from a single ectopic focus; each PVC is identical […] Multifocal arising from two or more ectopic foci; multiple QRS morphologies. The origin of each PVC can be discerned from the QRS morphology: PVCs arising from the right ventricle have a left bundle branch block morphology (dominant S wave in V1) […] PVCs arising from the left ventricle have a right bundle branch block morphology (dominant R wave in V1). Frequent PVCs may cause palpitations and a sense of the heart skipping a beat. In patients with underlying predispositions (e.g. ischaemic heart disease, WPW), a PVC may trigger the onset of a re-entrant tachydysrhythmia e.g. VT, AVNRT, AVRT. Frequent PVCs are usually benign, except in the context of an prolonged QTc, when they may predispose to malignant ventricular arrhythmias such as Torsades de Pointes by causing R on T phenomenon. PVCs are a normal electrophysiological phenomenon not usually requiring investigation or treatment.

• #8 Premature ventricular complexes: Clinical presentation and diagnostic evaluation – UpToDate

  https://www.uptodate.com/contents/ventricular-premature-beats

  In patients with no known heart disease, PVCs have been seen in approximately 1 percent of routine 12-lead electrocardiograms (ECG) of 30 to 60 seconds duration and up to 6 percent of ECGs of two minutes duration. […] By comparison, when 24-hour ambulatory monitoring is used, up to 80 percent of apparently healthy people have occasional PVCs. […] The occurrence of frequent PVCs accounting for more than 20 percent of overall heart beats is rare, seen in less than 2 percent of patients. […] There is an age-related increase in the prevalence of PVCs in normal individuals and those with underlying heart disease. The prevalence of PVCs increase with age and in the presence of other factors, such as faster sinus rate, hypokalemia, hypomagnesemia, and hypertension.

• #9 Premature ventricular contractions (PVCs) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/premature-ventricular-contractions-pvcs?content_id=CON-20376741

  If you don’t have PVCs very often, a standard ECG may not detect them. Your health care provider may ask you to use a portable ECG device at home to obtain more information about your heartbeats. […] Most people with premature ventricular contractions (PVCs) who don’t have heart disease won’t need treatment. If you have heart disease, PVCs can lead to more-serious heart rhythm problems (arrhythmias). Treatment depends on the underlying cause. […] A health care provider may recommend the following treatment for frequent PVCs: Lifestyle changes. Eliminating common PVC triggers such as caffeine or tobacco may reduce the number of extra beats and lessen symptoms. […] Tests are done to confirm a diagnosis of premature ventricular contractions.

• #10 Premature Ventricular Contractions (PVC): Symptoms, Cause, Treatment

  https://www.webmd.com/heart-disease/premature-ventricular-contractions-facts

  Premature Ventricular Contraction Diagnosis […] Even if you’ve never had symptoms, you may be diagnosed with PVCs during a routine heart test called an electrocardiogram (ECG). If you come in with symptoms of PVCs, you’ll get the same test. During this test, sticky patches with sensors called electrodes are put on your chest. They record electrical impulses that travel through your heart. […] The test only takes a few minutes, and that may not be long enough to notice an occasional PVC. In that case, you may get a portable ECG. There are two types: […] Another type of ECG is called an exercise stress test. It’s like a standard ECG, but it’s done while you’re on a bike or a treadmill. If PVCs don’t happen often during this test, that’s a sign that they probably are harmless. If exercise seems to cause extra beats, you may be at a higher risk of other heart rhythm problems. […] If you have a lot of PVCs or have had them for a long time, your doctors might order more tests to see if you have other conditions that might need attention. The tests might include: […]

• #11 Clinical Approach to Patients with Frequent PVCs | Sarver Heart Center

  https://heart.arizona.edu/heart-health/heart-rhythm-disorders/clinical-approach-patients-frequent-pvcs

  Premature ventricular complexes, or PVCs, are a common clinical problem. […] The 12-lead EKG is very useful in identifying the PVC morphology, as certain clinical syndromes exhibit very characteristic PVC morphologies. […] Holter monitoring can help correlate PVCs to symptoms and is a suitable tool to quantify PVC frequency. […] Once PVCs are documented it is often useful to proceed with an echocardiogram to evaluate for underlying structural heart disease and exercise stress testing to assess the impact of physical activity on PVCs. […] PVCs in patients with structural heart disease such as LVH, cardiomyopathy, and congestive heart failure, prior myocardial infarction, etc. […] A more subtle form of cardiomyopathy, arrhythmogenic right ventricular dysplasia, which typically presents with a left bundle branch PVC pattern, also needs to be considered.

• #12 Premature Ventricular Contractions (PVCs) Causes, Symptoms, Management

  https://www.medicinenet.com/premature_ventricular_contractions/article.htm

  What are the treatments for premature ventricular contractions? […] The reasons for treating premature ventricular contractions are to relieve symptoms of palpitations, to treat conditions that cause premature ventricular contractions since many conditions that cause premature ventricular contractions are potentially life-threatening, and to prevent ventricular tachycardia and sudden death. […] How are premature ventricular contractions diagnosed (EKG and Holter)? […] PVCs can be demonstrated during Holter monitoring. However, not all premature ventricular contractions found during Holter monitoring are clinically important.

• #13 Ventricular Premature Complexes: Causes, Symptoms, and More

  https://www.healthline.com/health/ventricular-preamture-complexes

  Ventricular premature complexes can be difficult to diagnose. If these irregular heartbeats occur randomly, your doctor may not be able to detect them during your appointment. […] If you report symptoms of ventricular premature complexes to your doctor, they may order additional tests to confirm the diagnosis. These tests may include: […] Electrocardiogram (ECG) This imaging test records the electrical actions of the heart, including the speed of the heartbeats. […] Echocardiogram This imaging technique uses sound waves to project a moving picture of your heart onto a screen, providing the doctor with very detailed images of the hearts chambers and valves. […] Coronary angiography In this test, a catheter is placed in an artery, usually in the groin or the arm, and then carefully moved until its in the heart. A contrast agent is then pumped into the catheter and monitored through X-ray images, allowing doctors to observe how blood is flowing through your heart. […] Holter monitor This is a device that your doctor will give you to take home and wear. It records your hearts activity over a 24-hour period. […] Event recorder Similar to a Holter monitor, this is a device that you wear. It records heart activity when you experience a skipped heartbeat.

• #14 Premature Ventricular Contractions

  https://www.rwjbh.org/treatment-care/heart-and-vascular-care/diseases-conditions/premature-ventricular-contractions/

  Premature Ventricular Contractions (PVCs) are extra heartbeats that begin in one of your heart’s two lower pumping chambers (ventricles). These extra beats disrupt your regular heart rhythm. They are a type of heart arrhythmia. If you have occasional premature ventricular contractions, but you’re otherwise healthy, there’s probably no reason for concern, and no need for treatment. If you have frequent premature ventricular contractions or underlying heart disease, you might need treatment. […] Typically, your doctor will perform the following diagnostic tests and procedures: […] Electrocardiogram (EKG/ECG) […] Stress test […] Holter monitor […] Event recorder.

• #15 Diagnosis and Treatment of Idiopathic Premature Ventricular Contractions: A Stepwise Approach Based on the Site of Origin

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8534438/

  A careful analysis of ECG features can help to predict the SOO and plan the procedure. […] Initial patient evaluation should include detailed clinical history with focus on inherited arrhythmic syndromes, cardiomyopathies and familiar history of SCD, adrenergic substances consumption and metabolic disorders such as hyperthyroidism. […] Beyond the prediction of the SOO, resting ECG may rise the suspicion of underlying SHD in presence of depolarization or repolarization abnormalities including q waves, QRS fragmentation and inverted T waves. […] Exercise stress test should always be part of the initial diagnostic work-up, as exercise-induced PVCs or induction of SVT, as well as frequent PVCs occurring during the recovery phase are all markers of increased risk, even in the absence of myocardial ischemia.

• #16 Evaluation of Premature Ventricular Contractions in Children with Structurally Normal Hearts: A Single-Center Study – The Journal of Pediatric Research

  https://jpedres.org/articles/evaluation-of-premature-ventricular-contractions-in-children-with-structurally-normal-hearts-a-single-center-study/doi/jpr.galenos.2024.60094

  In our study, unlike the information in the current literature, it was determined that propafenone had a more successful clinical response than other medical treatments. […] In addition to the absence of structural heart disease, the absence of a family history of arrhythmia and the reduction of PVCs with exercise have been evaluated as good prognoses in many studies. […] Additionally, it is known that the detection of VT during diagnosis negatively affects the prognosis of PVCs. Supporting this information, no regression was observed in PVCs in any of the check-up Holter ECGs of our patients with VT accompanying PVCs at the time of diagnosis, and their VT rates were found to be higher compared to those without VT at baseline. […] PVCs are classified as frequent if they are 10% in 24 hours, and it is well known that this group of patients should be constantly monitored for the development of cardiomyopathy.

• #17 Diagnosis and Treatment of Idiopathic Premature Ventricular Contractions: A Stepwise Approach Based on the Site of Origin

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8534438/

  Although PVCs commonly occur in subjects with morphologically normal hearts, it is crucial to exclude an underlying SHD due to its impact on the therapeutic approach and risk stratification. […] In this regard, cardiac imaging plays a central role. […] The main advantage of CMR as compared to TTE lies in the unlimited number of imaging planes, which allows optimal assessment of complex three-dimensional structures, such as the RV. […] Furthermore, CMR offers non-invasive myocardial characterization capabilities, enabling the detection of fatty infiltration, fibrosis and myocardial edema, which are key elements of the substrate underpinning PVCs in SHD. […] In addition to diagnostic purposes, the identification and localization of myocardial fibrosis is also important for proper planning of CA and carries significant prognostic implications as the presence of CMR abnormalities has been correlated with increased risk of malignant arrhythmic events during long-term follow-up.

• #18 Premature Ventricular Contractions | Diagnosis | UK Healthcare

  https://ukhealthcare.uky.edu/gill-heart-vascular-institute/conditions/arrhythmias/premature-ventricular-contractions/diagnosis

  To diagnose PVCs and help rule out other heart conditions, your healthcare provider might perform certain tests. […] During your initial office visit, your healthcare provider will spend time with you and learn more about your symptoms and overall health. […] Blood samples can provide information about electrolyte issues, such as thyroid hormone, magnesium and potassium levels. […] An echocardiogram (echo) is a type of ultrasound that shows the function and structure of your heart. […] An electrocardiogram (ECG or EKG) records the electrical activity in your heart through electrodes attached to the body and connected to a machine with wires. […] For this test, you will walk on a treadmill or ride a stationary bicycle while connected to heart-monitoring equipment. […] A patch monitor is a battery-operated ECG that sticks to your chest.

• #19 Diagnosis and Treatment of Idiopathic Premature Ventricular Contractions: A Stepwise Approach Based on the Site of Origin

  https://www.mdpi.com/2075-4418/11/10/1840

  Although PVCs commonly occur in subjects with morphologically normal hearts, it is crucial to exclude an underlying SHD due to its impact on the therapeutic approach and risk stratification. […] The main advantage of CMR as compared to TTE lies in the unlimited number of imaging planes, which allows optimal assessment of complex three-dimensional structures, such as the RV. […] In patients with PVC-induced cardiomyopathy, amiodarone is reasonable to reduce the PVC burden, improve symptoms and left ventricular function. […] However, in the last two decades, with progressive improvement in mapping techniques and CA outcomes, CA has become a first-line therapeutic option especially, when a PVC CMP is suspected. […] The planning of the ablative procedure starts with the identification of the possible SOO by careful evaluation of the 12-lead ECG, and this specific approach must be tailored taking into account the anatomical structures that are in close proximity and susceptible to injury.

• #20 Premature Ventricular Contractions | PVC Heart Condition Causes & Symptoms

  https://heartofdixiecardiologycenter.com/premature-ventricular-contractions-pvc/

  An echocardiogram is an ultrasound of the heart and is useful in assessing the overall size and function of the heart’s chambers, walls, and valves. Even if you have no symptoms or only minimal symptoms, patients with a high PVC burden require follow-up with an echocardiogram because of the association between frequent PVCs and arrhythmia-induced cardiomyopathy (weakening of the heart). […] Because of the known association between PVCs and heart disease, it is common for people with PVCs—especially PVCs that occur frequently or with a certain morphology—to undergo stress testing to rule out signs of ischemia. […] The reasons for treating premature ventricular contractions are to relieve symptoms of palpitations, to treat conditions that cause premature ventricular contractions since many conditions that cause premature ventricular contractions are potentially life-threatening, and to prevent ventricular tachycardia and sudden death. […] For individuals who experience occasional PVCs with no other symptoms and no underlying heart disease or structural problems, no treatment is necessary.

• #21 When to Worry About Premature Ventricular Complexes (PVCs)

  https://www.verywellhealth.com/premature-ventricular-complexes-pvcs-1745222

  To help determine if your PVCs are benign, your healthcare provider will want to assess several things from the history and physical exam, laboratory evaluation, and cardiac imaging tests. […] In general, an echocardiogram, which is an ultrasound of your heart, is the main way to screen for most underlying heart conditions. […] Once it’s understood exactly what is going on with the heart and that it is common and not dangerous, you may be less likely to become anxious when PVCs occur. […] Regular follow-up with a primary care physician is recommended for patients with infrequent PVCs, no symptoms, and a normal LVEF. […] For those with frequent PVCs but no symptoms and a normal LVEF, yearly echocardiograms and follow-up with a cardiologist are advised. […] Managing PVCs is not a straightforward matter, as their impact can vary from person to person.

• #22 Premature ventricular contractions: Reassure or refer? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/83/7/524

  When patients present with palpitations, the primary care physician can perform the initial evaluation and treatment for premature ventricular contractions (PVCs). Many patients need only reassurance and do not need to see a cardiologist. […] The focus of the initial evaluation is to determine whether there is underlying structural heart disease. If there is, early referral to a specialist is probably warranted. […] Idiopathic PVCs (in which there is no structural heart disease) have a benign prognosis. […] Treatment of PVCs is indicated for relief of symptoms if reassurance is not sufficient. […] Patients who have a high PVC burden ( 10% of total heartbeats, though this is a subject of debate) should have an evaluation of their systolic function. If it is normal at baseline, periodic follow-up echocardiograms should be considered.

• #23 Premature ventricular contraction – Wikipedia

  https://en.wikipedia.org/wiki/Premature_ventricular_contraction

  A premature ventricular contraction (PVC) is a common event where the heartbeat is initiated by Purkinje fibers in the ventricles rather than by the sinoatrial node. PVCs may cause no symptoms or may be perceived as a „skipped beat” or felt as palpitations in the chest. PVCs do not usually pose any danger. […] The electrical events of the heart detected by the electrocardiogram (ECG) allow a PVC to be easily distinguished from a normal heart beat. However, very frequent PVCs can be symptomatic of an underlying heart condition (such as arrhythmogenic right ventricular cardiomyopathy). Furthermore, very frequent (over 20% of all heartbeats) PVCs are considered a risk factor for arrhythmia-induced cardiomyopathy, in which the heart muscle becomes less effective and symptoms of heart failure may develop. Ultrasound of the heart is therefore recommended in people with frequent PVCs.

• #23 Premature ventricular contraction – Wikipedia

  https://en.wikipedia.org/wiki/Premature_ventricular_contraction

  PVCs may be found incidentally on cardiac tests such as a 12-lead electrocardiogram (ECG/EKG) performed for another reason. In those with symptoms suggestive of premature ventricular complexes, the ECG/EKG is the first investigation that may identify PVCs as well as other cardiac rhythm issues that may cause similar symptoms. […] On electrocardiography (ECG or Holter) premature ventricular contractions have a specific appearance of the QRS complexes and T waves, which are different from normal readings. By definition, a PVC occurs earlier than the regular normally conducted beat. Subsequently, the time between the PVC and the next normal beat is longer as the result of a compensatory pause. […] PVCs can be distinguished from premature atrial contractions because the compensatory pause is longer following premature ventricular contractions, in addition to a difference in QRS appearance.

• #24 Premature Ventricular Contractions (PVCs): Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/heart/arrhythmias/premature-ventricular-contractions-pvcs/treatment

  Cardiac MRIs or CT scans – These imaging tests produce clear and detailed pictures of the heart, surrounding structures, and the blood flow. They can highlight structural damage that could be causing PVCs. […] Angiograms – An angiogram is a scan that uses dye to highlight how well blood flows through arteries and veins. This test can detect blood vessel blockage, structural heart damage, or other heart diseases which could cause PVCs. […] Electrophysiology study – This test uses catheters and wire electrodes to measure the electrical activity of the heart, which can diagnose arrhythmia (abnormal heartbeats)

• #25 Premature Ventricular Contractions (PVCs) Causes, Symptoms, Management

  https://www.medicinenet.com/premature_ventricular_contractions/article.htm

  How are premature ventricular contractions diagnosed (echo and stress test)? […] Echocardiography is useful in diagnosing conditions that can cause premature ventricular contractions such as mitral valve prolapse, muscle hypertrophy, heart muscle damage, and ejection fraction. […] Exercise cardiac stress testing (ECST) is the most widely used cardiac stress test. […] How is premature ventricular contraction diagnosed (ECST and blood tests)? […] Blood tests for diagnosing conditions that can cause premature ventricular contractions to include: blood electrolyte levels can be performed to detect low potassium or magnesium levels (hypokalemia and hypomagnesaemia); blood drug levels can be performed to detect digoxin and aminophylline drug toxicity or thyroid levels; blood oxygenation (oximetry) can be measured to detect hypoxia; blood tests can be performed to detect illicit drugs; and blood levels of cardiac enzymes can be performed to assess for heart muscle damage as a result of heart attacks.

• #26 Association of Premature Ventricular Contraction (PVC) with hematological parameters: a data mining approach | Scientific Reports

  https://www.nature.com/articles/s41598-025-86557-z

  Premature ventricular contraction (PVC) is characterized by early repolarization of the myocardium originating from Purkinje fibers. PVC may occur in individuals who are otherwise healthy. However, it may be associated with some pathological conditions. In this research the association between hematological factors and PVC was studied. The association of hematological factors with PVC was evaluated using different machine learning (ML) algorithms, including logistic regression (LR), C5.0, and boosting decision tree (DT). According to the models, RDW and PLT were the most significant hematological factors for both males and females. Some hematological factors associated with PVC were found using ML models. Given these findings, it is proposed that some hematological factors may also be associated with PVC. The complete blood count (CBC) is commonly requested in clinical practice. Previous studies have shown that CBC components are associated with certain cardiac diseases, such as coronary heart disease, left ventricular hypertrophy, and endothelial dysfunction. In addition, it has been reported that PVC is associated with ventricular dysfunction. Moreover, it has been shown that CBC components may be prognostic in patients with ventricular dysfunction and predict ventricular dysfunction. The results of C5.0 were better than the LR model for both males and females. Based on the final tree among males, WBC, PLT, RDW, PDW, and HCT had the greatest importance in PVC presence. Also, among females, the DT model showed that PVC presence mostly was impacted by RBC, PLT, RDW, MCV, and MXD. This study revealed a significant association between MCV and PVC. In conclusion, this study investigated whether it was possible to predict PVC using routinely measured hematological factors through the utilization of advanced machine learning algorithms. The most important hematological factors associated with PVC in both males and females were RDW and PLT. For males WBC, PDW, and HCT, and females, RBC, MCV, and MXD were also important.

• #27 Diagnosis and Treatment of Idiopathic Premature Ventricular Contractions: A Stepwise Approach Based on the Site of Origin

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8534438/

  The planning of the ablative procedure starts with the identification of the possible SOO by careful evaluation of the 12-lead ECG, and this specific approach must be tailored taking into account the anatomical structures that are in close proximity and susceptible to injury. […] In patients with recurrent ventricular fibrillation triggered by PVCs often the SOO lies in the Purkinije network. […] In such cases, CA is a standardized approach to avoid further malignant arrhythmic events.

• #28 A Diagnostic dilemma – Bradycardia with Premature Ventricular Contraction – Southern Medical Association

  https://sma.org/abstracts/a-diagnostic-dilemma/

  Case presentation and diagnosis: A 59-year-old African-American female presented with dizziness and lightheadedness for around 1 month. […] Her EKG showed sinus rhythm with PVCs-unifocal with a right bundle branch block/superior axis morphology likely originating from a focus around the Left Ventricle (LV) apex and not ischemic. […] Management: It was both a diagnostic and therapeutic dilemma to manage bradycardia and symptomatic PVCs. It was decided to initiate therapy with metoprolol succinate (MS) 25 mg daily with monitoring of her ventricular rate at home and flecainide 50 mg twice daily. […] It was decided to consider telemetry for evaluation and possible EP and ablation if PVCs burden continues to remain high.

• #29 When to worry about premature ventricular contractions (PVCs)

  https://www.healthline.com/health/arrhythmia/when-to-worry-about-pvc

  If PVCs affect your quality of life or make you very anxious, talk with a doctor. Multiple interventions can help you feel better. […] Occasional PVCs are usually not problematic to you or your health. But if you have too many in a row, your heart may not pump enough blood, and your blood pressure will drop. This can make you feel faint and dizzy. […] According to a 2017 report, having more than 10,000 and up to 20,000 PVCs a day can decrease your hearts function. […] Doctors refer to this as PVC-induced cardiomyopathy. Its reversible in most patients if the PVCs are treated. […] If your doctor has already diagnosed heart disease, PVCs can increase your mortality risk or risk for early death. Talk with them about how to minimize your risks. […] Most healthcare professionals wont recommend treating PVCs unless they are causing you significant symptoms.

• #30 Premature Ventricular Complex – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK547713/

  The accepted thinking is that cardiomyopathy is more likely in patients whose PVCs have a very wide QRS complex, the beats arise from the epicardium, or in patients with PVC occurring higher than a quarter of all beats on 24-hour Holter monitor (PVC burden of over 25%). […] Frequent PVCs are often associated with complications if remain unattended, which include left ventricular dysfunction, dilated cardiomyopathy, sustained ventricular tachycardia, and sudden cardiac arrest.

• #30 Premature Ventricular Complex – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK547713/

  Premature ventricular complexes (PVCs), or premature ventricular contractions, are ectopic heartbeats originating from the ventricles. Common across diverse populations, they may occur in patients with or without preexisting cardiac conditions. While often benign and asymptomatic, frequent PVCs can cause symptoms, eg, palpitations, dizziness, or fatigue, and may lead to progressive left ventricular dysfunction, which can be reversed with treatment such as catheter ablation. […] Diagnosed primarily via 12-lead electrocardiogram, they present as prolonged QRS complexes and may be classified by coupling intervals, QRS duration, morphology, or patterns (eg, bigeminy, trigeminy, or runs of ventricular tachycardia). Evaluation includes history, electrocardiogram, Holter monitoring, and imaging to rule out structural heart disease.

• #31 Diagnosis and Treatment of Idiopathic Premature Ventricular Contractions: A Stepwise Approach Based on the Site of Origin

  https://www.mdpi.com/2075-4418/11/10/1840

  In a clinical scenario when it is suspected that a high PVCs burden (>15–25%) may play a significant role in LV dysfunction, CA can help to improve LVEF. […] In patients with recurrent ventricular fibrillation triggered by PVCs often the SOO lies in the Purkinije network. […] Compared to PVCs originating from the RVOT, ablation of PVCs originating from the LVOT is more complex and can involve greater procedural risk due to nearby anatomical structures such as coronary arteries or aortic valve cusps.

• #32 Diagnosis and Treatment of Idiopathic Premature Ventricular Contractions: A Stepwise Approach Based on the Site of Origin

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8534438/

  The available evidence on the prognostic impact of idiopathic PVCs in terms of risk of death and heart failure is conflicting. […] Some studies have reported the prognosis of asymptomatic patients with frequent PVCs superimposable to that of the general population, while others have found an increased risk of heart failure and death including SCD. […] These data should be carefully interpreted as the major prognostic element in patients presenting with PVCs is represented by the presence of underlying SHD. […] In a clinical scenario when it is suspected that a high PVCs burden (15-25%) may play a significant role in LV dysfunction, CA can help to improve LVEF. […] Medical therapy should be considered as first-line therapy in patients in whom ablation is more complex and leads to a higher risk of procedural complications, but in general, CA has a strong recommendation in symptomatic patients who do not tolerate or do not prefer long-term AAD.

• #33 Premature Ventricular Complex – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK547713/

  PVCs usually originate from the ventricle, leading to a prolonged QRS complex duration greater than 120 ms because of the delay in the spread of activation to the contralateral ventricle through the nonspecialized myocardium. […] The 12-lead electrocardiogram (ECG) helps identify the precise location of the origin of PVCs only by the morphology of ectopic beats. […] The initial workup should start with a resting ECG. The PVC is electrocardiographically defined as a premature QRS complex with an abnormal morphology and duration greater than 120 milliseconds. […] Patients with PVCs in the setting of underlying structural heart disease should receive guideline-directed medical therapy (GDMT) as indicated in their specific disease process. […] PVC ablation is also the recommended intervention in patients who develop PVC-induced cardiomyopathy, especially in those with a significant PVC burden.

• #34 Premature Ventricular Contractions (PVCs): Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/heart/arrhythmias/premature-ventricular-contractions-pvcs

  Premature ventricular contractions (PVCs) are extra heartbeats originating in the lower pumping ventricles of the heart that disrupt the regular heart rhythm, causing an irregular heartbeat. […] If your heart palpitations are bothersome or cause you concern, contact your doctor. An examination by your doctor can determine whether these symptoms are due to another condition like an overactive thyroid (hyperthyroidism), low red blood cell count (anemia), hypoglycemia, anxiety, or an infection that could exhibit similar signs. […] A cardiologist can investigate and offer treatment if the condition continues to be an issue. […] However, experiencing frequent PVCs could indicate a more serious heart condition, and a cardiologist visit is highly recommended. […] Frequent PVCs could disrupt the hearts electrical impulses and eventually lead to irregular heart rhythms (arrhythmias) or heart muscle weakening (cardiomyopathy). […] NewYork-Presbyterian physicians offer clinical trials for cardiovascular disease using the most cutting-edge techniques and treatments available, including PVCs.

• #35 Premature Ventricular Contractions in Athletes: Insight into Evaluation and Management

  https://www.acc.org/Latest-in-Cardiology/Articles/2022/05/27/16/19/Premature-Ventricular-Contractions-in-Athletes

  Those with high burden, uncommon morphologies, or symptomatic PVCs require further evaluation as outlined in the Table 1. […] If the above testing is normal in the setting of benign asymptomatic PVCs, then no further evaluation is needed.4 Abnormal findings or those with high-risk features often require further testing dependent on the suspected disease. […] A beta blocker is typically first line therapy in those with PVCs. […] Importantly, beta blockers are prohibited by the World Anti-Doping Agency (WADA) in only sports that rely on stability of the upper extremities, such as archery, racing, golf, shooting. […] The decision regarding sport participation should be a shared one. In general, PVCs alone are not disqualifying, and even if there is an underlying cardiomyopathy, with appropriate risk stratification and treatment, many athletes can return to play. […] Evaluation and management of PVCs in athletes is complex and requires detailed history taking and comprehensive evaluation to rule out an underlying myocardial disease. Accurate risk-stratification, diagnosis, and shared decision making are key for optimal management.

• #36 Premature Ventricular Complexes Differential Diagnoses

  https://emedicine.medscape.com/article/158939-differential

  Differentiating PVCs from other arrhythmias can be challenging, because several arrhythmias may mimic PVCs, as discussed below. Note that patients with PVCs may be predisposed to or have underlying cardiomyopathy, heart failure, or sudden cardiac death. […] The diagnosis of PVCs is primarily electrocardiogaphic. […] Rarely, when catheters are present in the heart (as for electrophysiologic studies, or with implanted cardiac devices capable of telemetry), PVCs can be definitively diagnosed by establishing the earliest temporal origin or an extrasystole in the ventricles. […] Often, however, this is not true and PVCs must be imperfectly diagnosed on the basis of surface electrocardiographic data. […] In this case, an important consideration is distinguished PVCs from other supraventricular extrasystoles that result in a broader QRS complex, typically from aberration. […] Thus, data from multiple leads must be evaluated: Depending on the origin of the PVC and the specific surface ECG lead observed, occasionally, a PVC may appear narrower than the sinus complex, but it still is generally broader when all leads are considered together.

• #37 Electrocardiographic Characteristics, Identification, and Management of Frequent Premature Ventricular Contractions

  https://www.mdpi.com/2075-4418/13/19/3094

  PVCs have consistently been associated with adverse cardiovascular outcomes among patients with pre-existing structural heart disease. […] The association between the presence of PVCs in patients with apparently normal hearts and adverse cardiovascular outcomes has been a matter of debate. […] The decision to treat idiopathic PVCs should be based upon the presence of symptoms or the development of PVC-induced myocardial dysfunction. […] Therapeutic options include medical treatment and catheter ablation. […] Catheter ablation demonstrates superior efficacy and safety compared with anti-arrhythmic drug therapy, especially in RVOT-originating arrhythmias.

• #38 Premature Ventricular Contraction-induced Cardiomyopathy | AER Journal

  https://www.aerjournal.com/articles/premature-ventricular-contraction-induced-cardiomyopathy?language_content_entity=en

  Premature ventricular contractions (PVCs) are very common and usually do not require treatment. However, in the clinical setting of troublesome symptoms, or when PVCs trigger polymorphic ventricular tachycardia or cause cardiomyopathy, proper treatment is critical. […] The three indications for treatment are symptom control, to prevent recurrence in PVC-triggered ventricular fibrillation and to potentially reduce the effects of PVC-induced cardiomyopathy. […] The concept of PVC-induced cardiomyopathy was first proposed by Duffee and coworkers, who observed a small group of patients with cardiomyopathy recover normal left ventricular (LV) function after pharmacological suppression of frequent PVCs. […] An early description of the potential effect of catheter ablation on PVC-induced cardiomyopathy by Yarlagadda et al. seems prescient.

• #39 Premature Ventricular Contractions (PVCs)

  https://my.clevelandclinic.org/health/diseases/17381-premature-ventricular-contractions

  Your provider may recommend other tests if you have many PVCs or have had them for a long time. These tests check for root causes of PVCs, including other heart problems. […] Treatment for underlying heart conditions may decrease the frequency of PVCs. […] Sometimes, your provider offers specific PVC treatment. You only need treatment specifically for a PVC if you have frequent irregular heartbeats that could damage your heart muscle. […] PVCs aren’t usually an emergency. Call 911 and go to your nearest emergency center if you experience other symptoms along with PVCs, including: […] PVCs can increase your risk of sudden cardiac death if you have underlying structural heart disease or if they arise from specific areas in your heart. However, in most people, PVCs are benign and don’t lead to sudden cardiac death. […] PVCs aren’t dangerous in most people. Your risk of PVC complications increases if you have other health conditions, including heart disease.

• #40 Asymptomatic ventricular extrasystoles

  https://www.escardio.org/Councils/Council-for-Cardiology-Practice-(CCP)/Cardiopractice/asymptomatic-ventricular-extrasystoles

  Advanced diagnostic methods are rarely necessary for isolated asymptomatic PVCs. […] However, according to the latest ESC guidelines, catheter ablation holds a class I indication for patients with PVC-induced cardiomyopathy and predominantly monomorphic PVCs, irrespective of symptoms. […] The management of PVCs is primarily guided by the patients symptoms. In asymptomatic cases, treatment may still be considered, particularly with the aim of reducing PVC burden in the hope of achieving favourable prognostic outcomes. […] If there are indications that lifestyle-related factors are contributing to the onset or exacerbation of PVCs such as caffeinated beverages, inadequate sleep, or stress, the initial step should be to minimise or eliminate these triggers.

• #41 Premature ventricular contractions: Reassure or refer? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/83/7/524

  Patients with a very high burden ( 20%) are at high risk of arrhythmia-induced cardiomyopathy. In these patients, referral is prudent, as some patients may opt for more aggressive treatment of their PVCs. […] In patients with severe symptoms for whom medical management has failed, referral for consideration of catheter ablation is reasonable.

• #42 Premature Ventricular Contraction-induced Cardiomyopathy | AER Journal

  https://www.aerjournal.com/articles/premature-ventricular-contraction-induced-cardiomyopathy?language_content_entity=en

  Subsequent investigations have focused on distinguishing risk factors for the development of cardiomyopathy in patients with PVCs. […] The authors concluded that although PVC-related cardiomyopathy may occur in patients with less PVCs, in the presence of a PVC burden 24 %, it may be prudent to suppress the PVCs by catheter ablation or drug therapy to avoid the development of cardiomyopathy. […] In summary, PVC-mediated cardiomyopathy requires a high index of suspicion to identify based on the presence of cardiomyopathy plus PVCs, rather than frequent PVCs in isolation. Typical patients have a high burden of PVCs with a single morphology usually from the right or left outflow tract and no history of previous structural heart disease. Successful treatment, particularly when provided relatively early in the disease process, allows recovery of LV dysfunction.

• #43 Premature ventricular complexes (PVC)-induced cardiomyopathy: A review and meta-analysis of pathophysiology, diagnosis and clinical management

  https://oatext.com/premature-ventricular-complexes-pvc-induced-cardiomyopathy-a-review-and-meta-analysis-of-pathophysiology-diagnosis-and-clinical-management.php

  This seminal study inspired subsequent research on the role of PVCs in patients with DCM and other non-ischemic forms of CM. […] However, recent studies have demonstrated the potential detrimental effect of frequent PVCs in patients with structurally normal hearts and the development and reversibility of PVC-induced CM. […] Despite the increasing recognition of PICM both in scholarly discourse and in clinical practice, its exact prevalence both in the general population and in patients with structural heart diseases remain unknown. […] The exact mechanisms underlying the development of PICM is not entirely clear. […] However, several postulations exist that attempt to explain the pathophysiology of PICM. […] The primary treatment target of PICM is the suppression of PVCs. […] In the present meta-analysis, RFA is a common and efficacious therapy for PICM patients.

• #44 Premature ventricular complexes (PVC)-induced cardiomyopathy: A review and meta-analysis of pathophysiology, diagnosis and clinical management

  https://oatext.com/premature-ventricular-complexes-pvc-induced-cardiomyopathy-a-review-and-meta-analysis-of-pathophysiology-diagnosis-and-clinical-management.php

  Diagnosis of PICM is by exclusion. […] Demonstration of a high PVC burden, LV systolic dysfunction and reversible LV dysfunction with ablation in the absence of other known causes of LV dysfunction confirms PICM. […] The mainstay therapy of PICM is PVC suppression through either pharmacotherapy or RFA.

• #45 Clinical Approach to Patients with Frequent PVCs | Sarver Heart Center

  https://heart.arizona.edu/heart-health/heart-rhythm-disorders/clinical-approach-patients-frequent-pvcs

  In patients with significant structural heart disease, PVCs often show multiple morphologies, making catheter ablation not the ideal therapeutic choice. […] It should be noted that none of the above therapies, with the exception of catheter ablation, can completely eliminate PVCs and symptoms. […] PVCs and symptoms related to PVCs are seen frequently in clinical practice, can occur in patients with or without structural heart disease, and often require therapy to improve symptoms. […] Assess PVC morphology on 12 lead EKG. […] Correlate PVCs to symptoms by event monitoring. […] Quantify PVC frequency with a Holter monitor. […] Evaluate for potential structural heart disease.

• #46 Premature ventricular contractions – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/premature-ventricular-contractions/

  A 12-lead ECG confirms the diagnosis. […] Specialized testing (e.g., Holter monitor, cardiac imaging) may be indicated to: […] Rule out underlying structural disease […] Assess PVC burden, i.e., the proportion of PVCs per total number of beats. […] A 1-minute rhythm strip may help identify PVCs on ECG. […] PVCs are a common incidental finding on routine ECGs. No advanced workup is required in asymptomatic patients without indications for additional testing.

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