Premature Ventricular Contractions (PVCs)
Premature ventricular contractions (PVCs) are a type of irregular heartbeat, also called an arrhythmia. PVCs are extra heartbeats. They start in one of the heart’s lower chambers, called the ventricles. The extra beats change the usual pattern of the heartbeat.
Premature ventricular contractions also are called:
- Premature ventricular complexes.
- Ventricular premature beats.
- Ventricular extrasystoles.
If you don’t have heart disease, PVCs may not be a concern. You may not need treatment. You might need treatment if the irregular beats are very frequent or bothersome or if you have an underlying heart condition.
Premature ventricular contractions (PVCs) may not cause symptoms. Sometimes the extra beats can cause unusual feelings in the chest, such as:
- Fluttering, pounding or jumping heartbeats.
- Skipped beats or missed beats.
The changes may make you more aware of your heartbeat.
When to see a doctor
If you feel changes in your heartbeat, make an appointment for a health checkup. A healthcare professional can figure out if your symptoms are due to a heart condition or other health concern.
To understand the cause of premature ventricular contractions (PVCs), it may help to know how the heart works.
How does the heart beat?
The typical heart has four chambers.
- The two upper chambers are called the atria.
- The two lower chambers are called the ventricles.
The heart’s electrical system controls the heartbeat. The heart’s electrical signals start in a group of cells at the top of the heart called the sinus node. They pass through a pathway between the upper and lower heart chambers called the atrioventricular node. This pathway also is called the AV node. The movement of the signals causes the heart to squeeze and pump blood.
In a healthy heart, this heart signaling process usually goes smoothly. The heart at rest beats about 60 to 100 times a minute.
But if you have premature ventricular contractions (PVCs), the heartbeats are not regular. The PVCs start in the lower heart chambers instead of the upper ones. The beats start sooner than typically expected.
Typical heartbeat
In a typical heart rhythm, a tiny cluster of cells at the sinus node sends out an electrical signal. The signal then travels through the upper heart chambers, called the atria, to the atrioventricular node (AV node). The signal then goes into the lower heart chambers, called the ventricles. This makes the chambers squeeze and pump blood.
The cause of PVCs isn’t always clear. Some things, including heart diseases or changes in the body, can make cells in the lower heart chambers electrically unstable. Heart disease or scarring may cause the heart’s electrical signals to take the wrong path.
Premature ventricular contractions may be caused by:
- Some medicines, including decongestants and antihistamines.
- Alcohol or drug misuse.
- Stimulants such as caffeine or tobacco.
- Higher levels of adrenaline in the body due to exercise or anxiety.
- Injury to the heart muscle due to disease.
Some lifestyle choices and health conditions may make a person more likely to have premature ventricular contractions (PVCs).
Risk factors for PVCs include:
- Use of caffeine or illicit drugs such as cocaine or methamphetamines.
- Smoking and using tobacco.
- Alcohol use.
- Exercise, for certain types of PVCs.
- Anxiety.
- Heart attack.
- Coronary artery disease.
- Heart condition that a person is born with, called a congenital heart defect.
- Heart failure, a weakened heart muscle and other heart conditions.
Possible complications of premature ventricular contractions (PVCs) may include:
- Other types of irregular heartbeats.
- Weakening of the heart muscle, called cardiomyopathy.
In some people with heart disease, frequent PVCs can cause dangerous heartbeat changes that lead to sudden cardiac death. This complication is rare.
To diagnose premature ventricular contractions (PVCs), a healthcare professional examines you. You usually are asked questions about your medical history and lifestyle habits. The health professional listens to your heart with a tool called a stethoscope.
Tests
Tests are done to diagnose premature ventricular contractions (PVCs) and learn their cause.
- Electrocardiogram (ECG or EKG). This simple test shows how the heart is beating. It can diagnose PVCs. Sticky patches with sensors on them go on the chest and sometimes the arms and legs. Wires connect the sensors to a computer, which displays or prints the results.
- Holter monitor. This is a small, wearable ECG device that records the heartbeat. If you don’t have PVCs very often, a regular ECG may not find them. So your healthcare team may ask you to wear this device for a day or more during daily activities. Some personal devices, such as smartwatches, offer portable ECG monitoring. Ask your healthcare professional if this is an option for you.
- Event monitor. This is another type of portable ECG device. You wear it for up to 30 days or until you have an irregular heartbeat or symptoms. You usually press a button when symptoms happen. Some event monitors automatically spot irregular heartbeats and start recording.
- Exercise stress test. This test often involves walking on a treadmill or riding a stationary bike while the heart’s activity is watched. An exercise stress test can show whether exercise triggers PVCs.
Most people with premature ventricular contractions (PVCs) don’t have heart disease and won’t need treatment. If you have heart disease, PVCs can lead to more-serious irregular heartbeats. Treatment depends on the cause.
Treatment for frequent PVCs may include:
- Lifestyle changes. Not using caffeine or tobacco may reduce symptoms and lead to fewer irregular beats.
- Medications. You may need blood pressure medicines if you have frequent PVCs or if you have an irregular heartbeat called ventricular tachycardia. Examples of these medicines are beta blockers and calcium channel blockers. They help reduce the extra heartbeats.
- Radiofrequency catheter ablation. If lifestyle changes and medicines don’t lower the number of extra beats, this treatment may be done to stop them. In this treatment, one or more thin flexible tubes called catheters are placed into an artery and guided to the heart. Sensors on the tip of a catheter use heat, called radiofrequency energy, to create tiny scars in the heart. Heart signals can’t pass through these scars. So this treatment helps restore the usual heartbeat.
References
- Manolis AS. Premature ventricular complexes: Clinical presentation and diagnostic evaluation. https://www.uptodate.com/contents/search. Accessed May 15, 2025.
- What is an arrhythmia? National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/arrhythmias. Accessed May 15, 2025.
- Premature contractions — PACs and PVCs. American Heart Association. https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/premature-contractions-pacs-and-pvcs. Accessed May 15, 2025.
- Jalife J, et al., eds. Premature ventricular complexes. In: Zipes and Jalife’s Cardiac Electrophysiology: From Cell to Bedside. 8th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed May 15, 2025.
- Medical review (expert opinion). Mayo Clinic. Dec. 17, 2021.
- Kim JH, et al. Clinical considerations for competitive sports participation for athletes with cardiovascular abnormalities: A scientific statement from the American Heart Association and American College of Cardiology. Circulation. 2025; doi:10.1161/CIR.0000000000001297.
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