VENTRICULAR EXTRASYSTOLE WITHOUT STRUCTURAL HEART DISEASE: DIAGNOSIS AND MANAGEMENT

Premature ventricular contractions (PVCs) are one of the most common arrhythmias, with a population prevalence of 1% on 12-lead electrocardiogram (ECG) (1). PVCs are often found in asymptomatic patients, but episodic or prolonged symptoms may occur (2). Diagnostic methods include 12-lead ECG and 24-hour Holter monitoring to assess QRS morphology and PVC frequency (3). Addi­tional tests such as transthoracic cardiac ultrasound and cardiac magnetic resonance imaging (MRI) are neces­sary to evaluate structural heart diseases or left and right ventricular functions.

For patients without structural heart disease and infrequ­ent, asymptomatic PVCs, medical treatment is usually not prescribed. Factors provoking rhythm disorder and lifes­tyle are corrected (4). If PVCs are symptomatic or frequ­ent, drug treatment is prescribed. In the case of frequ­ent PVCs causing changes in the structure and function of the heart (cardiomyopathy), interventional treatment such as radiofrequency ablation (RDA) is suggested (5). Treatment should focus on diagnosing and treating com­mon causes, such as electrolyte abnormalities and illegal psychotropic substances that can increase catecholamine levels in the blood. Beta-adrenoblockers are the drugs of first choice in the treatment of symptomatic PVCs. Cat­heter ablation of the arrhythmia focus is recommended for patients in whom medical treatment is ineffective (6).

The objective is to review the literature on the causes of PVCs without structural heart disease and treatment recommendations, as well as to describe a clinical case to assess the importance of choosing the appropriate tre­atment method for such patients.