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Ventricular Premature Beats

(Ventricular Ectopic Beats; Premature Ventricular Contractions)

By L. Brent Mitchell, MD, Professor of Medicine, Department of Cardiac Services, Libin Cardiovascular Institute of Alberta, University of Calgary

A ventricular premature beat is an extra heartbeat resulting from abnormal electrical activation originating in the ventricles (the lower chambers of the heart) before a normal heartbeat would occur.

  • The main symptom is a perception of a skipped heartbeat.

  • Electrocardiography is used to make the diagnosis.

  • Avoiding things that trigger these beats, such as stress, caffeine, and alcohol, is usually sufficient treatment.

Ventricular premature beats are common, particularly among older people. This arrhythmia may be caused by physical or emotional stress, intake of caffeine (in beverages and foods) or alcohol, or use of cold or hay fever remedies containing drugs that stimulate the heart, such as pseudoephedrine. Other causes include coronary artery disease (especially during or shortly after a heart attack) and disorders that cause ventricles to enlarge, such as heart failure and heart valve disorders.


Isolated ventricular premature beats have little effect on the pumping action of the heart and usually do not cause symptoms, unless they are extremely frequent. The main symptom is the perception of a strong or skipped beat (palpitations). Ventricular premature beats are not dangerous for people who do not have a heart disorder. However, when they occur frequently in people who have a structural heart disorder (such as a heart valve disorder or a heart attack), they may be followed by more dangerous arrhythmias such as ventricular tachycardia or ventricular fibrillation, which can cause sudden death.


  • Electrocardiography

Electrocardiography (ECG) is used to diagnose ventricular premature beats.


  • Lifestyle changes

  • Sometimes beta-blockers

In an otherwise healthy person, no treatment is needed other than decreasing stress and avoiding caffeine, alcohol, and over-the-counter cold or hay fever remedies containing drugs that stimulate the heart.

Drug therapy is rarely used because the risk of side effects due to the drugs is usually greater than the benefit. The exception is people who recently had a heart attack or who have heart failure that causes symptoms. In such people, survival is improved if they are treated with beta-blockers (see Table: Some Drugs Used to Treat Arrhythmias).

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