A detailed clinical approach to patients with frequent premature ventricular contractions (PVCs) typically involves several steps:
History and physical examination: The healthcare provider will take a detailed medical history and perform a physical examination to assess the patient's overall health and identify any underlying conditions that may be contributing to the PVCs.
Laboratory tests: The healthcare provider may order laboratory tests such as a complete blood count (CBC), electrolyte levels, and thyroid function tests to rule out any underlying medical conditions that may be causing the PVCs.
Diagnostic imaging studies: The healthcare provider may order diagnostic imaging studies such as an electrocardiogram (ECG) or echocardiogram to assess the patient's heart function and identify any structural abnormalities that may be contributing to the PVCs.
Holter Monitoring: A Holter monitor is a portable device that a patient wears for 24 to 48 hours to record their heart rhythm. This will help to identify the frequency and duration of PVCs.
Tilt table test: In some cases, a tilt table test may be performed to evaluate for potential causes of PVCs such as neurally mediated syncope.
Treatment: Based on the results of the evaluation, the healthcare provider will determine the appropriate course of treatment. This may include:
lifestyle modifications, such as avoiding triggers that can worsen PVCs, such as caffeine, alcohol, and tobacco
Medications, such as beta-blockers, calcium channel blockers, or antiarrhythmic medications to help control the frequency of PVCs.
In some cases, more invasive procedures such as an ablation may be recommended to eliminate the focus of PVCs.
Follow-up: Regular follow-up with the healthcare provider is important to monitor the patient's condition and make any necessary adjustments to the treatment plan.
It is important to note that while PVCs are usually benign, they can be a sign of an underlying heart condition, so it is important to consult with a cardiologist to determine the best course of action. In some cases, PVCs may be a sign of a more serious condition such as cardiac ischemia, cardiomyopathy or even a form of heart failure. Therefore, it's important that the patient's symptoms and clinical condition are closely monitored and that any underlying cardiac conditions are identified and treated early. Dr. A. Arrazaghi. MD,FRCPC