What is the role of early diagnosis and treatment of acute ischemia or infarction in patients with premature ventricular contractions (PVCs)?

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

Early diagnosis and treatment of acute infarction/ischemia are the cornerstones of therapy. Note the following:

  • Routine use of lidocaine and other type I antiarrhythmic agents in the setting of acute MI is no longer recommended, because of their toxic effects
  • Acute ischemia or infarction includes patients with ectopy in the period immediately after receipt of thrombolytic agents, during which complex ectopy frequently is seen
  • First-line therapy for ectopy without hemodynamic significance in patients who have sustained a myocardial infarction (MI) is beta-blockade
  • Only in the setting of symptomatic, complex ectopy is lidocaine likely to benefit a patient having an MI
  • Lidocaine is especially useful when symptomatic ectopy is associated with a prolonged QT interval, in that it does not lengthen the QT interval as other antiarrhythmic agents do
  • Amiodarone [12] is also a useful agent for suppressing ectopy or ventricular tachycardia (if hemodynamically significant); additional beneficial effects include coronary vasodilation and increased cardiac output via a reduction in systemic vascular resistance

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!