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Premature ventricular complexes: diagnostic and therapeutic considerations in clinical practice

A state-of-the-art review by the American College of Cardiology Electrophysiology Council

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Abstract

Premature ventricular complexes (PVCs) are common arrhythmias in the clinical setting. PVCs in the structurally normal heart are usually benign, but in the presence of structural heart disease (SHD), they may indicate increased risk of sudden death. High PVC burden may induce cardiomyopathy and left ventricular (LV) dysfunction or worsen underlying cardiomyopathy. Sometimes PVCs may be a marker of underlying pathophysiologic process such as myocarditis. Identification of PVC burden is important, since cardiomyopathy and LV dysfunction can reverse after catheter ablation or pharmacological suppression. This state-of-the-art review discusses pathophysiology, clinical manifestations, how to differentiate benign and malignant PVCs, PVCs in the structurally normal heart, underlying SHD, diagnostic procedures (physical examination, electrocardiogram, ambulatory monitoring, exercise testing, echocardiography, cardiac magnetic resonance imaging, coronary angiography, electrophysiology study), and treatment (lifestyle modification, electrolyte imbalance, medical, and catheter ablation).

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Authors and Affiliations

  1. Department of Cardiology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey

    Bulent Gorenek

  2. Montefiore-Einstein Cardiology Division, Arrhythmia Service, Albert Einstein College of Medicine, Bronx, NY, USA

    John D. Fisher

  3. Adana, Turkey

    Gulmira Kudaiberdieva

  4. Center for Postgraduate Education and Research; SRI of Heart Surgery and Organ Transplantation, Bishkek, Kyrgyzstan

    Gulmira Kudaiberdieva

  5. Division of Cardiology, Kingston Health Science Center, Queen’s University, Kingston, Ontario, Canada

    Adrian Baranchuk & Andrés Enriquez

  6. Cardiology Department, Geneva University Hospital, Geneva, Switzerland

    Haran Burri

  7. Division of Cardiology, Duke University Hospital, Durham, NC, USA

    Kristen Bova Campbell

  8. Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA

    Mina K. Chung

  9. Department of Cardiology, University Hospital and University Antwerp, Antwerp, Belgium

    Hein Heidbuchel

  10. Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, NY, USA

    Valentina Kutyifa

  11. Division of Cardiology, Section of Cardiac Electrophysiology, Rush University Medical Center, Chicago, IL, USA

    Kousik Krishnan

  12. Service de Cardiologie et Maladies Vasculaires, CHU Rennes, Rennes, France

    Christophe Leclercq

  13. Department of Cardiology, Dokuz Eylul University School of Medicine, Izmir, Turkey

    Emin Evren Ozcan

  14. Division of Cardiology, University of Washington, Seattle, WA, USA

    Kristen K. Patton

  15. Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ, USA

    Win Shen

  16. Department of Pharmacy Practice, College of Pharmacy, Purdue University, Indianapolis, IN, USA

    James E. Tisdale

  17. Division of Clinical Pharmacology, Department of Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA

    James E. Tisdale

  18. Department of Cardiovascular Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Mohit K. Turagam

  19. Kansas City Heart Rhythm Institute & Research Foundation, Overland Park, KS, 66221, USA

    Dhanunjaya Lakkireddy

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  1. Bulent Gorenek
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  2. John D. Fisher
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  18. Dhanunjaya Lakkireddy
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Correspondence to Bulent Gorenek.

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Gorenek, B., Fisher, J.D., Kudaiberdieva, G. et al. Premature ventricular complexes: diagnostic and therapeutic considerations in clinical practice. J Interv Card Electrophysiol 57, 5–26 (2020). https://doi.org/10.1007/s10840-019-00655-3

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  • DOI: https://doi.org/10.1007/s10840-019-00655-3

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