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EXTRA BEATS (PREMATURE VENTRICULAR ECTOPICS (ECG (premature beats, usually…
EXTRA BEATS
PREMATURE VENTRICULAR ECTOPICS
Complexes originating from an extopic focus within the ventricles
incidence of this phenomenon inc with age and more common in pts with concomitant IHD
usually benign as well, unless associated with prolonged QT interval
majority are asymptomatic but as in premature atrial ectopics, may present with palpitations in symptomatic pts
ECG
premature beats
usually followed by a compensatory pause
broad QRS
MANAGEMENT
B-blocker or verapamil if symptomatic
radiofrequency catheter ablation if severe (more effective than anti-arrhythmic)
No treatment required if asymptomatic
PROGNOSIS
Excellent if structurally normal heart
inc risk of sudden death if LVEF <40%
PREMATURE ATRIAL ECTOPICS
More common in pts with conditions that cause elevated atrial pressures such as mitral valve disease, HTN, HF, also may related to electrolyte abnormalities and drugs.
these beats represent a normal electrophysiological phenomenon and the majority of pts are asymptomatic
symptomatic individuals may experience palpitations or dizziness
ECG
P waves often hidden in preceding T wave - abnormal looking T wave
Reduced PR interval (<0.12s)
Abnormal P wave followed by normal QRS complex
MANAGEMENT
Usually benign and treatment is symptomatic
B-blockers, verapamil or flecainide may be considered
PROGNOSIS
Inc risk of CVS mortality (stroke, sudden cardiac death), associated with new AF