From the Guidelines
PVCs are primarily caused by early electrical impulses originating in the ventricles, and their frequency increases with age, with common causes including caffeine, alcohol, tobacco, stress, anxiety, fatigue, and electrolyte imbalances, as well as certain medications and underlying medical conditions such as heart disease and hyperthyroidism. The causes of PVCs can be multifactorial, and it is essential to identify and address any underlying conditions that may be contributing to their occurrence. According to the 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death 1, PVCs are common and increase in frequency with age, with longer term monitoring showing PVCs in about 50% of all people with or without heart disease. Some of the key factors that can contribute to the development of PVCs include:
- Caffeine, alcohol, tobacco, stress, anxiety, and fatigue
- Electrolyte imbalances, particularly low potassium or magnesium
- Certain medications, such as decongestants, antihistamines, and some antidepressants
- Underlying medical conditions, including heart disease, previous heart attack, heart failure, heart valve problems, cardiomyopathy, high blood pressure, hyperthyroidism, and sleep apnea
- Certain illegal drugs, such as cocaine or methamphetamine. It is crucial to note that while PVCs can be benign in individuals with a structurally normal heart, frequent or symptomatic PVCs may require treatment, which can involve addressing underlying causes, such as reducing caffeine and alcohol intake, managing stress, correcting electrolyte abnormalities, or adjusting medications, as well as the use of medications like beta-blockers or calcium channel blockers in cases where PVCs are due to heart disease or are highly symptomatic 1.
From the FDA Drug Label
Flecainide acetate tablets, USP cause a dose-related and plasma-level related decrease in single and multiple PVCs and can suppress recurrence of ventricular tachycardia In limited studies of patients with a history of ventricular tachycardia, flecainide acetate tablets, USP have been successful 30 to 40% of the time in fully suppressing the inducibility of arrhythmias by programmed electrical stimulation.
The causes of PVCs are not directly stated in the provided drug labels. However, it can be inferred that flecainide is used to treat PVCs, suggesting that the drug may be effective in managing the condition.
- PVCs may be related to underlying cardiac disease or other factors, but the exact causes are not specified in the labels.
- The labels do mention that flecainide can cause proarrhythmic effects, including an increase in frequency of PVCs or the development of more severe ventricular tachycardia 2, 2.
From the Research
Causes of PVCs
- PVCs arise from an ectopic focus within the ventricles 3
- Underlying causes of PVCs include:
- PVCs can be a sign of underlying cardiac disease and can cause significantly impairing symptoms 6
- PVCs have been known to cause tachycardia-induced cardiomyopathy in patients without preceding structural heart disease 4
- The frequency and complexity of PVCs is associated with mortality, especially in ischemic heart disease 5
- PVC-induced cardiomyopathy can occur when there is a high burden of PVCs with specific characteristics 7, 3