Recommendations
In 2006, the American College of Cardiology, American Heart Association, and European Society of Cardiology published their Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death.3
The TABLE summarizes characteristics of patients with PVCs who were at higher risk of underlying cardiac disease and death. All patients with PVCs should have a history and physical examination, electrocardiogram, and electrolyte studies. Higher-risk patients should be considered for further evaluation, including stress testing, echocardiography, and ambulatory electrocardiogram (SOR: C, opinion).
TABLE
Characteristics of patients with PVCs who are at higher risk of cardiac disease/death
| PATIENT CHARACTERISTICS | LOWER RISK | HIGHER RISK |
|---|---|---|
| Morphology | Unifocal PVCs<10 PVCs per hour | Complex multifocal PVCs Ventricular tachycardia Ventricular fibrillation >10 PVCs per hour |
| Symptoms | Asymptomatic | Palpitations Presyncope Syncope |
| Preexisting conditions | None | Known history of CAD Structural heart disease Valvular heart disease Cardiomyopathy |
| CAD, coronary artery disease, PVCs, premature ventricular contractions. | ||
| Source: American College of Cardiology et al.3 | ||