What are the diagnostic criteria for ventricular premature complexes (VPCs)?

Updated: Nov 26, 2016
  • Author: Jatin Dave, MD, MPH; Chief Editor: Jose M Dizon, MD  more...
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Answer

Diagnostic criteria include the following:

  • Wide (duration exceeding the dominant QRS complexes) and bizarre QRS complexes are present.

  • No preceding premature P waves occur, and, rarely, a sinus P wave is conducted.

  • The T wave usually is in the opposite direction from the R wave.

  • Full compensatory pause is common.

  • VPCs originating from the left ventricle typically produce a right bundle-branch block (BBB) pattern on QRS.

  • VPCs originating from right ventricle typically produce left BBB-like pattern on QRS.

  • Idiopathic VPCs often originate from the right ventricular outflow tract and have a left bundle inferior axis morphology. See the image below.

    Ventricular premature complexes (VPCs). Ventricula Ventricular premature complexes (VPCs). Ventricular trigeminy is present. Note that the VPCs are unimorphic and that a compensatory pause follows each VPC. This patient has asymptomatic idiopathic VPCs originating from the right ventricular outflow tract.

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