Skip to main content

The Elusive Ventricular Extra-Beat

  • 676 Accesses


An extra beat arising in the lower chambers of the heart is commonly referred to as a ventricular premature complex (VPC). It is a common arrhythmia and is often benign. However, it can cause unnerving symptoms such as palpitations, chest-thumping, strong or hard beats, and skipped beats. In this chapter, the prevalence, clinical presentation, and types and origins and treatment of VPCs are discussed.


lab/dab ------ lab/dab --- dab ------------- lab/dab

My heart skips: the ventricular premature beat¬

the heart tumbles, the chest heaves

pain, dizziness, delirium.

What is it white knight?

An impending infarction, or death?

Out of my lungs, the last breath?

lab/dab ------ lab/dab --- dab ------------- lab/dab

—Modified from Mirrored Reflections, António Gomes

This is a preview of subscription content, log in via an institution.

Buying options

USD   19.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   29.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions


  1. 1.

    Grade 0, no VPCs; grade I, less than 30 per hour; grade II, more than 30 per hour; grade III, multiform, that is, more than one ECG morphology. Three of our 20 interns had multiform VPCs; grade IVA, couplets or two VPCs in a row. Two of our interns had couplets. Grade IVB, three or more consecutive beats or non-sustained ventricular tachycardia (“non-sustained” because it terminates on its own); grade V, R on T VPCs (i.e., a VPC superimposed on the T wave of the preceding beat)

Author information

Authors and Affiliations


Corresponding author

Correspondence to J. Anthony Gomes .

Rights and permissions

Reprints and permissions

Copyright information

© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Gomes, J.A. (2021). The Elusive Ventricular Extra-Beat. In: Rhythms of Broken Hearts. Springer, Cham.

Download citation

  • DOI:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-77381-6

  • Online ISBN: 978-3-030-77382-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics