What are the emergency department procedures for patients with premature ventricular contractions (PVCs)?

Updated: Jan 13, 2017
  • Author: James E Keany, MD, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Answer

The decision to treat PVCs in the emergency or outpatient settings depends on the clinical scenario. In the absence of cardiac disease, isolated, asymptomatic ventricular ectopy, regardless of configuration or frequency, requires no treatment. With cardiac disease, certain toxic effects, and electrolyte imbalances, treatment may be required. Establish telemetry and IV access, initiate oxygen, and obtain a 12-lead electrocardiogram (ECG). Note the following:

  • Hypoxia - Treat the underlying cause; secure the ABCs and provide oxygen.
  • Drug toxicity - Specific therapy is indicated for certain toxic effects—for example, digoxin (Fab antibodies), tricyclics (bicarbonate), and aminophylline (gastrointestinal decontamination and possibly hemodialysis)
  • Correct electrolyte imbalances, particularly those of magnesium, calcium, and potassium

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