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ClearRounds Health · Cardiology · Quick Reference
PVCs
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Arrhythmias & DevicesBeginnerIn progressOne-page PDF
PVC burden, symptoms, workup, electrolytes, beta blockers, cardiomyopathy threshold, and EP referral.
Last reviewed
Pending initial clinical review
Sources / guidelines to verify
- 2017 AHA/ACC/HRS Ventricular Arrhythmias & SCD Guideline
Disclaimer: Educational reference only. Not a substitute for clinician judgment, local protocols, or current guideline review.
One-page reference
Draft content pending the site owner’s clinical review. Verify against the sources above and local protocol before clinical use.
1
What it is / why it matters
- Premature ventricular beats — common and usually benign.
- A high burden can cause a reversible cardiomyopathy.
2
Key diagnostic clues
- “Skipped beats”/palpitations, irregular pulse; Holter quantifies the burden (% of beats).
3
Initial workup
- ECG and Holter/extended monitor for burden; echo for LV function.
- Electrolytes (K⁺/Mg²⁺), TSH; exclude ischemia if indicated.
4
Management framework
- Reassure if low burden and a structurally normal heart; reduce triggers (caffeine/stimulants).
- Beta-blocker or CCB for symptoms.
- Burden >10–15% and/or LV dysfunction → EP referral, consider ablation.
5
Red flags / escalate now
- PVCs with syncope, family SCD history, structural disease, very high burden, or declining EF → cardiology/EP.
6
Follow-up / monitoring
- Echo if high burden (PVC-induced cardiomyopathy); trend symptoms/burden.
7
Clinic pearls
- Burden matters — >10–15% can cause a reversible cardiomyopathy.
- Correct low K⁺/Mg²⁺; multifocal or structural PVCs warrant more workup than benign monomorphic ones.
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