What is the role of Holter monitoring in the workup of 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

In high-risk patients, ie, those with reduced ejection fraction (EF) and VPCs, a 24-hour Holter monitor may help establish the degree of electrical instability.

The severity of LV dysfunction, along with the complexity and frequency of the VPC, determines the aggressiveness of management.

Suppression of VPCs by beta-blocker or calcium blocker, together with a typical VPC morphology (inferior axis, LBBB morphology) can be helpful in establishing typical right ventricular outflow tract ectopy.

Suppressing the VPCs themselves is not the focus of treatment unless patients are significantly symptomatic.

Treatment of the underlying structural heart disease also is extremely important. This includes acute syndromes, such as ischemia and infarction, the treatment of which involves reperfusion. [16]


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