What Are Premature Ventricular Contractions (PVCs)?
PVCs are extra, early heartbeats that originate from the ventricles (lower chambers of your heart) instead of the normal pacemaker in the upper chambers—they are extremely common, occurring in about 50% of all people on long-term heart monitoring, and usually don't require treatment unless they're very frequent or causing symptoms. 1
What PVCs Feel Like
Most people with PVCs don't feel anything at all. 1 When you do notice them, PVCs typically feel like:
- A "skipped beat" or pause in your heartbeat 2
- A fluttering or flip-flopping sensation in your chest 2
- A strong or forceful heartbeat (the beat after the PVC feels stronger than normal) 2
- A brief sensation that your heart stopped momentarily 2
Some people experience fatigue or shortness of breath with exertion when PVCs are very frequent (more than 10% of all heartbeats). 3
What Causes PVCs
In Healthy People
PVCs are incredibly common in people with completely normal hearts and increase naturally with age—only 0.6% of people under 20 have them on a standard ECG, but 2.7% of people over 50 do, and half of all adults have them on extended monitoring. 1 In young, healthy individuals with good exercise capacity, isolated PVCs are generally benign. 4
Common Triggers
- Caffeine, alcohol, and stimulant medications 5
- Stress and fatigue 5
- Electrolyte imbalances (low potassium, magnesium, or calcium) 5
- Thyroid problems (hyperthyroidism) 5
- Infections and inflammatory conditions 5
Underlying Heart Conditions
- Coronary artery disease and previous heart attacks 5
- Heart failure 5
- Hypertrophic cardiomyopathy (thickened heart muscle) 5
- Valve disease 5
When PVCs Become a Problem
Very frequent PVCs—more than 10,000 to 20,000 per day or more than 10-15% of all heartbeats—can weaken the heart muscle over time, causing a condition called PVC-induced cardiomyopathy. 1, 5, 2 This is reversible if the PVCs are treated. 2, 6
Warning Signs That Require Evaluation
- Multiple PVCs (2 or more) on a single ECG 1, 4
- PVCs from different locations in the heart (multifocal) 1, 4
- Very wide PVC complexes (>160 milliseconds on ECG) 1, 4
- PVCs that increase with exercise rather than decrease 1, 4
- Family history of sudden cardiac death 4
- Symptoms like dizziness, fainting, or chest pain 1
The Bottom Line
If you have occasional PVCs and a normal heart, they're almost always harmless and don't need treatment. 4, 3 However, if PVCs are frequent (more than 10% of your heartbeats), cause bothersome symptoms, or you have underlying heart disease, evaluation by a cardiologist is important to determine if treatment is needed. 5, 4 Treatment options include medications or a procedure called catheter ablation that can eliminate the source of the PVCs. 2, 7