Premature ventricular contractions (PVCs)

PVCs are extra heartbeats that can make the heart beat out of rhythm. They are very common and may not be a concern. Learn when treatment is needed.

Update Date: 20.09.2025

Overview
Symptoms
When to see a doctor
Causes
Risk factors
Complications
Diagnosis
Treatment
Self care
Preparing for your appointment

Overview

Premature ventricular contractions (PVCs) are a type of irregular heartbeat, also called an arrhythmia. PVCs are extra heartbeats. They start in one of the heart's lower chambers, called the ventricles. The extra beats change the usual pattern of the heartbeat.

Premature ventricular contractions also are called:

  • Premature ventricular complexes.
  • Ventricular premature beats.
  • Ventricular extrasystoles.

If you don’t have heart disease, PVCs may not be a concern. You may not need treatment. You might need treatment if the irregular beats are very frequent or bothersome or if you have an underlying heart condition.

Symptoms

Premature ventricular contractions (PVCs) may not cause symptoms. Sometimes the extra beats can cause unusual feelings in the chest, such as:

  • Fluttering, pounding or jumping heartbeats.
  • Skipped beats or missed beats.

The changes may make you more aware of your heartbeat.

When to see a doctor

If you feel changes in your heartbeat, make an appointment for a health checkup. A healthcare professional can figure out if your symptoms are due to a heart condition or other health concern.

Causes

To understand the cause of premature ventricular contractions (PVCs), it may help to know how the heart works.

How does the heart beat?

The typical heart has four chambers.

  • The two upper chambers are called the atria.
  • The two lower chambers are called the ventricles.

The heart's electrical system controls the heartbeat. The heart's electrical signals start in a group of cells at the top of the heart called the sinus node. They pass through a pathway between the upper and lower heart chambers called the atrioventricular node. This pathway also is called the AV node. The movement of the signals causes the heart to squeeze and pump blood.

In a healthy heart, this heart signaling process usually goes smoothly. The heart at rest beats about 60 to 100 times a minute.

But if you have premature ventricular contractions (PVCs), the heartbeats are not regular. The PVCs start in the lower heart chambers instead of the upper ones. The beats start sooner than typically expected.

The cause of PVCs isn't always clear. Some things, including heart diseases or changes in the body, can make cells in the lower heart chambers electrically unstable. Heart disease or scarring may cause the heart's electrical signals to take the wrong path.

Premature ventricular contractions may be caused by:

  • Some medicines, including decongestants and antihistamines.
  • Alcohol or drug misuse.
  • Stimulants such as caffeine or tobacco.
  • Higher levels of adrenaline in the body due to exercise or anxiety.
  • Injury to the heart muscle due to disease.

Typical heartbeat

In a typical heart rhythm, a tiny cluster of cells at the sinus node sends out an electrical signal. The signal then travels through the upper heart chambers, called the atria, to the atrioventricular node (AV node). The signal then goes into the lower heart chambers, called the ventricles. This makes the chambers squeeze and pump blood.

Risk factors

Some lifestyle choices and health conditions may make a person more likely to have premature ventricular contractions (PVCs).

Risk factors for PVCs include:

  • Use of caffeine or illicit drugs such as cocaine or methamphetamines.
  • Smoking and using tobacco.
  • Alcohol use.
  • Exercise, for certain types of PVCs.
  • Anxiety.
  • Heart attack.
  • Coronary artery disease.
  • Heart condition that a person is born with, called a congenital heart defect.
  • Heart failure, a weakened heart muscle and other heart conditions.

Complications

Possible complications of premature ventricular contractions (PVCs) may include:

  • Other types of irregular heartbeats.
  • Weakening of the heart muscle, called cardiomyopathy.

In some people with heart disease, frequent PVCs can cause dangerous heartbeat changes that lead to sudden cardiac death. This complication is rare.

Diagnosis

To diagnose premature ventricular contractions (PVCs), a healthcare professional examines you. You usually are asked questions about your medical history and lifestyle habits. The health professional listens to your heart with a tool called a stethoscope.

Tests

Tests are done to diagnose premature ventricular contractions (PVCs) and learn their cause.

  • Electrocardiogram (ECG or EKG). This simple test shows how the heart is beating. It can diagnose PVCs. Sticky patches with sensors on them go on the chest and sometimes the arms and legs. Wires connect the sensors to a computer, which displays or prints the results.
  • Holter monitor. This is a small, wearable ECG device that records the heartbeat. If you don't have PVCs very often, a regular ECG may not find them. So your healthcare team may ask you to wear this device for a day or more during daily activities. Some personal devices, such as smartwatches, offer portable ECG monitoring. Ask your healthcare professional if this is an option for you.
  • Event monitor. This is another type of portable ECG device. You wear it for up to 30 days or until you have an irregular heartbeat or symptoms. You usually press a button when symptoms happen. Some event monitors automatically spot irregular heartbeats and start recording.
  • Exercise stress test. This test often involves walking on a treadmill or riding a stationary bike while the heart's activity is watched. An exercise stress test can show whether exercise triggers PVCs.

Treatment

Most people with premature ventricular contractions (PVCs) don't have heart disease and won't need treatment. If you have heart disease, PVCs can lead to more-serious irregular heartbeats. Treatment depends on the cause.

Treatment for frequent PVCs may include:

  • Lifestyle changes. Not using caffeine or tobacco may reduce symptoms and lead to fewer irregular beats.
  • Medications. You may need blood pressure medicines if you have frequent PVCs or if you have an irregular heartbeat called ventricular tachycardia. Examples of these medicines are beta blockers and calcium channel blockers. They help reduce the extra heartbeats.
  • Radiofrequency catheter ablation. If lifestyle changes and medicines don't lower the number of extra beats, this treatment may be done to stop them. In this treatment, one or more thin flexible tubes called catheters are placed into an artery and guided to the heart. Sensors on the tip of a catheter use heat, called radiofrequency energy, to create tiny scars in the heart. Heart signals can't pass through these scars. So this treatment helps restore the usual heartbeat.

Self care

The following self-care tips can help manage premature ventricular contractions (PVCs). These tips also may improve heart health.

  • Know your triggers. If you have frequent PVCs, keep a diary of the day and timing of symptoms. A diary may help show which foods, drinks or activities trigger the extra beats.
  • Limit or do not use stimulants. Caffeine, alcohol, tobacco and illicit drugs are known to cause premature ventricular contractions.
  • Ask about exercise. Some types of exercise may trigger premature ventricular contractions or make them worse. Ask your healthcare team what type and amount of exercise is safe for you.
  • Manage stress. Anxiety can trigger irregular heartbeats, including PVCs. Find ways to help reduce emotional stress. Some ideas to try are to practice mindfulness or connect with others in support groups. If you need help managing anxiety, talk to a healthcare professional about tips and medicines that may help.

Preparing for your appointment

You might start by seeing your family healthcare professional. You may be told to see a doctor trained in heart diseases, called a cardiologist.

Here's some information to help you get ready for your appointment.

What you can do

Take someone with you to your appointment, if possible, to help you remember the information you receive.

Before you go, make a list of:

  • Your symptoms, how they feel and when they started.
  • Important medical information, including other recent health conditions and family history of heart disease.
  • All medicines, vitamins and other supplements you take and their dosages.
  • Questions to ask your healthcare team.

For premature ventricular contractions, questions to ask your healthcare team include:

  • What is the likely cause of my symptoms?
  • What tests do I need?
  • What treatment do you suggest, if any?
  • Do I need to change any of the medicines that I'm taking for other health conditions?
  • What lifestyle changes can I make to reduce my symptoms?
  • Do I need to stop using alcohol and caffeine?
  • What is my risk of long-term complications?
  • How will you check my health over time?

Don't hesitate to ask other questions.

What to expect from your doctor

Your healthcare team is likely to ask you questions, such as:

  • Do you always have symptoms, or do they come and go? If your symptoms come and go, when are they likely to occur?
  • Do you drink alcohol? If so, how much?
  • Do you use caffeine? If so, how much?
  • Do you smoke or use other tobacco?
  • Do you use illicit drugs?
  • How often do you feel stressed or anxious? What do you do to manage these feelings?

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