Premature Ventricular Beats
(Ventricular Premature Beats; Premature Ventricular Contractions; Ventricular Ectopic Beats)
by Laurie B. Rosenblum, MPH
A premature ventricular beat (PVB) is an extra heartbeat caused by abnormal electrical activity. It starts in the ventricles (the lower chambers of the heart) before a normal heartbeat occurs. PVB interferes with the heart’s normal rhythm and causes a pause before the next heartbeat.
PVBs are common, especially among the elderly. They can occur in people who are healthy, in which case they are harmless. However, when they occur after a heart attack or heart surgery, they can lead to dangerous heart rhythms.
The causes of PVBs include:
PVB frequency increases with age and PVBs are most common in the elderly. PVBs are also more common in men. Other factors that may increase your chances of PVBs:
In many cases, there are no symptoms. When symptoms do occur they can include:
In people with heart disease, PVBs can cause decreased blood flow from the heart to other parts of the body. This can produce lightheadedness and fainting.
Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to a cardiologist.
Tests may include:
In most cases, no treatment is needed. However, it can be helpful to reduce stress and avoid caffeine, alcohol, and tobacco. If a medication you are taking may be causing the PVBs, your doctor may change the medication or adjust the dosage.
You may need to take medication if you have significant symptoms from PVBs, have heart disease, or if the pattern of the PVBs indicates a risk of developing more serious heart rhythm problems. Beta-blockers are generally tried first since they are relatively safe medications. Antiarrhythmic medications may be used, but they may also increase the chances of developing dangerous heart rhythms. Other medications that may be used include calcium channel blockers. Talk with your doctor about the best treatment for you.
To help reduce your chances of PVBs:
American Heart Association
Heart Rhythm Society
Canadian Heart Rhythm Society
Heart and Stroke Foundation of Canada
Premature contractions—PACs and PVCs. American Heart Association website. Available at:
...(Click grey area to select URL)
Last reviewed December 2016. Accessed November 28, 2017.
Premature ventricular contractions (PVCs). EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated October 27, 2017. Accessed November 28, 2017.
Selzman KA, Gettes LS. Exercise-induced premature ventricular beats: Should we do anything differently? Circulation. 2004;109(20):2374-2375.
Ventricular premature beats (VPB). Merck Manual Professional Version website. Available at:
...(Click grey area to select URL)
Updated September 2017. Accessed November 28, 2017.
Last reviewed November 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC
Last Updated: 11/27/2017
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