title: Are premature ventricular contractions always harmless?
abstract: BACKGROUND
  Premature ventricular contractions (PVCs) are among the most prevalent arrhythmias. PVCs lead to haemodynamically insufficient heartbeats. Their presence is considered rather insignificant, but this widespread assumption is not supported by research evidence.
  
  
  METHODS
  We present three cases of patients commonly seen in daily general practice, with a range of presentations, varying from incidental (harmless) PVCs to frequent and potentially symptomatic PVCs.
  
  
  CONCLUSIONS
  In more frequent PVCs (> 10% heart beats) fatigue and exertional dyspnoea may occur. When > 20% of heart beats are PVCs, patients may develop cardiomyopathy and heart failure. Incidental PVCs are harmless. Anti-arrhythmic drug treatment should be considered in case of frequent PVCs but also catheter ablation appears an effective treatment option.
  
  
  CONCLUSIONS
  Altogether, PVCs may not be harmless, depending on their occurrence rate. Research data from primary care settings on epidemiology and natural course is needed.
authors.affiliation: Diagnostic Centre, Department of Integrated Care, Maastricht University Medical Centre , the Netherlands.
authors.forename: R A G
authors.initials: RA
authors.lastname: Winkens
authors.forename: P F
authors.initials: PF
authors.lastname: Höppener
authors.forename: J A
authors.initials: JA
authors.lastname: Kragten
authors.forename: M P
authors.initials: MP
authors.lastname: Verburg
authors.forename: H F J M
authors.initials: HF
authors.lastname: Crebolder
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D009202:Cardiomyopathies / Q000209:etiology; D017115:Catheter Ablation; D004417:Dyspnea / Q000209:etiology; D015716:Electrocardiography, Ambulatory; D005221:Fatigue / Q000209:etiology; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012720:Severity of Illness Index; D018879:Ventricular Premature Complexes / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: exertional dyspnoea; fatigue; premature ventricular contractions