PVCs - Off the Beaten Path

PVC stands for Premature Ventricular Contraction. This is a normal thing that the heart does, and you have probably felt one a few times in your life. It’s that flip-flop sensation in your chest that catches you for a few seconds. Usually it goes away on it’s own and you go about your life, but sometimes people develop frequent enough PVCs that they seek out their primary care.

I think about PVCs like a fire drill for the heart. Your heart has one main center that is responsible for sending the signal to beat. The signal comes from the same place each time, follows the same path down the middle of the heart, and the heart moves in response. This produces a nice uniform beat that you typically don’t feel going on. But if something were to happen to that main center responsible for sending out the signal to beat, then ————- nothing. Which would be bad, of course.

So the heart has a lot of back up centers that are able to also send the signal that results in the heart beating. Because these centers are located in a different area, the signal is sent out in a different wave resulting in a different movement of the heart. This sudden shift in heart movement can sometimes be felt, especially if you happen to be laying on your side at the time, which positions your heart closer to your chest wall.

Typically the back up center only sends a few test beats, and then the main center takes over again and all is well. If you feel off beats in your chest for a few seconds that go away and don’t cause you to feel bad otherwise, it’s probably a PVC. PVCs have a characteristic appearance on an EKG so they are easy to spot, though it can be difficult sometimes to catch a PVC if it only happens once or twice a day when you run an EKG. This is because an EKG shows only 10 seconds of heart beats. Instead, what may be recommended to ensure the flip flop sensation you feel (or what we refer to as palpitations) is just something harmless like a PVC, is an event monitor. A few EKG stickers are applied to your chest and report to a monitor, which you can also notate on when you feel the sensation to help pin point what’s happening at that time. These monitors can be worn for days or even weeks if needed.

Though most people have PVCs rarely, some people are actually bothered by frequent PVCs that can happen often, even hourly! It’s not a sign of a diseased heart, but it can be quite disturbing and so these patients are often referred to a cardiologist to discuss treatments. And of course you don’t want to just assume that if you feel palpitations they are just PVCs - talk it over with your primary care, and see if you might need some more investigating to be sure!