Ventricular Premature Beats

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KEY POINTS

• A ventricular premature beat (VPB) is an abnormal, extra heartbeat. Almost everyone has VPBs at some time.
• If your child has a healthy heart, VPBs are generally not dangerous and don’t need treatment. If your child has symptoms, your child may need medicine to control the extra beats or an ablation to block the abnormal beats.
• Follow your child’s healthcare provider's instructions. Ask your child's healthcare provider if there are activities your child should avoid and when he can return to his normal activities.

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What are ventricular premature beats?

A ventricular premature beat (VPB) is an abnormal, extra heartbeat. Almost everyone has VPBs at some time. They are more likely as you get older.

VPBs are a medical problem only if your child has heart disease. Frequent VPBs and a weak heart muscle increase the risk of sudden death.

VPBs may also be called premature ventricular contractions or ventricular premature contractions.

What is the cause?

An electrical signal in your child’s heart starts each heartbeat, causing the heart muscle to squeeze (contract). Normally, this signal starts in the upper right chamber of the heart (the right atrium) at a place called the sinus node. The signal then travels to the upper left atrium and to the lower chambers of the heart (the ventricles). A VPB starts from one of the lower heart chambers instead of the right atrium. This may happen if your child:

• Has a scar in the heart muscle from an earlier injury or surgery
• Has too little oxygen getting to the heart because of heart disease
• Takes medicines, such as stimulants, diet pills, or decongestants
• Takes in too much caffeine or alcohol
• Use amphetamines or cocaine
• Is under stress
• Receives a blow to the chest
• Has low levels of potassium or magnesium in the blood

Often the cause of VPBs is not known. VPBs can happen even though your child has a healthy heart.

What are the symptoms?

Your child may not be aware of VPBs. Or he may notice "flip-flops" or skipped beats with an odd feeling in the chest. They may happen rarely or often.

How is it diagnosed?

Your healthcare provider will ask about your child's symptoms and medical history and examine your child.

Your child will have an ECG (also called an EKG or electrocardiogram), which measures and records the heartbeat. Your child may have an ECG while resting or while he exercises on a treadmill. Your child may also be asked to wear a small portable ECG monitor for a few days or longer.

To help diagnose the cause of VPBs, your child may have an echocardiogram, which uses sound waves (ultrasound) to see how well the heart is pumping.

How is it treated?

If your child has a healthy heart, VPBs are generally not dangerous and don’t need treatment. Making changes in lifestyle or diet, drinking less caffeine, and knowing that the VPBs are not dangerous may help reduce anxiety and decrease the number of VPBs.

If VPBs cause severe symptoms, treatment may include:

• Medicine to slow your child’s heartbeat
• Ablation, which uses a small tube called a catheter to deliver electrical pulses to the inside of the heart. The electrical pulses make small scars that block abnormal electrical pathways. This helps your child have a regular heart rhythm.
• An implantable cardiac defibrillator (ICD), which is a device that can shock the heart back to a regular rhythm.

How can I take care of my child?

Follow your child’s healthcare provider's instructions. Ask your provider:

• How and when you will get your child’s test results
• How long it will take to recover
• If there are activities your child should avoid and when he can return to his normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup.