Ján Kmec
Ventricular arrhythmias have various forms and clinical significance. Premature ventricular complexes (PVCs) disturb
the normal rhythm and originate from irritable foci situated within the ventricular conduction system or in muscle tissue.
PVCs are a frequent cause of palpitations and often an accidental finding on a routine electrocardiography (ECG)
or ambulatory ECG. In the healthy population PVCs are detected in about 1% in a standard 12-lead ECG readings, their
prevalence is increasing with age and is more frequent in men. The first step in evaluating a patient with PVCs is to determine
the presence or absence of structural cardiac disease. Indications and choice of treatment of ventricular arrhythmias
considering the severity of symptoms and prognostic significance of arrhythmia, which is determined by the
nature of the given arrhythmia itself, the underlying heart disease, left ventricular function, the coronary arteries findings,
and overall condition of the patient. In patients with symptomatic forms of PVCs in absence of significant heart
diseases we usually avoid administration of antiarrhythmic drugs. The treatment of choice is psychotherapy or anxiolytics
and small doses of beta-blockers. In patients with structural heart disease the crucial point of successful management
of ventricular arrhythmias and the prevention of sudden cardiac death is the effective management of the underlying
disease and co-morbidities. We can indicate beta-blockers or amiodarone, the effect of which on total mortality
is rather neutral, but it can reduce the rate of arrhythmic death. Ablation therapy is indicated when PVCs are frequent
and lead to progression of ventricular dysfunction.