• Premature Ventricular Contractions (PVCs)

    1. General information
      1. Irritable impulses originate in the ventricles
      2. Caused by electrolyte imbalance (hypokalemia); digitalis drug therapy; myocardial disease; stimulants (caffeine, epinephrine, isoproterenol); hypoxia; congestive heart failure
    2. Assessment findings
      1. Rate: varies according to number of PVCs
      2. Rhythm: irregular because of PVCs
      3. P wave: normal; however, often lost in QRS complex
      4. P-R interval: often not measurable
      5. QRS complex: wide and distorted in shape, greater than 0.12 seconds
    3. Treatment
      1. IV push of lidocaine (50-100 mg) followed by IV drip of lidocaine at rate of 1-4 mg/minute
      2. Procainamide (Pronestyl), quinidine
      3. Treatment of underlying cause

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