Premature ventricular contractions in patients without structural heart disease

Premature ventricular contractions (PVC) represent a daily problem for cardiologists due to their frequent occurrence. In the absence of structural heart disease, PVC are mainly benign. Initial work-up includes ECG, Holter-ECG, stress test and echocardiography. Whereas echocardiography can eliminate a patent cardiopathy, the other 3 exams evaluate PVC characteristics (morphology, daily rate, polymorphism, repetitive form, R/T phenomenon) to find an etiology and evaluate their arrhythmic risk. The daily PVC number is not a risk factor for dangerous arrhythmia, however it can lead to heart failure in some cases. Polymorphism and also R/T phenomenon indicate a possible arrhythmic risk. Careful evaluation is required before treatment, which is needed only in symptomatic patients or patients with a risk of severe ventricular arrhythmia. (C) 2009 Elsevier Masson SAS. All rights reserved.