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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