Ventricular Premature Beats (VPBs)

What are ventricular premature beats (VPBs)?

A ventricular premature beat (VPB) is an extra heartbeat that starts from one of the lower heart chambers (ventricles). (A normal heartbeat starts from the right upper chamber (atrium) of the heart.) VPBs may also be called premature ventricular contractions or ventricular premature contractions. Almost everyone has VPBs at some time, particularly as they get older. VPBs may happen rarely or they may happen often.

VPBs are 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?

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

Sometimes, something happens to make a part of the heart's ventricle muscle electrically unstable, causing the extra heartbeat. The electrical instability can be caused by:

• a scar in the heart muscle
• too little oxygen getting to the muscle because of heart disease
• medicines such as pseudoephedrine
• caffeine or alcohol
• a blow to the chest
• imbalance of electrolytes (body minerals) in the body.

What are the symptoms?

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

How is it diagnosed?

An electrocardiogram (ECG) is the only test that can confirm a diagnosis of VPBs. The ECG records the electrical activity of your heart. A 24-hour tape recording of the ECG shows when you have VPBs. It also shows how many occurred. These recordings can help your healthcare provider decide on treatment.

How is it treated?

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

If you often have 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.