The phrase “my heart skipped a beat” is often used in the context of falling in love, but beyond this, it could be a sign of a medical condition known as premature ventricular contraction (PVC).
According to Dr How Ann Kee, consultant cardiologist and electrophysiologist at a hospital in Sunway City, Subang Jaya, PVCs are common. “Some people feel them, while others don’t. Some have them detected only through an electrocardiogram (ECG) during a health screening.”
While up to 50% of people have experienced it at some point, PVCs should not be disregarded, especially if they interfere with normal heart function or cause significant problems.
PVCs, also known as arrhythmia, are caused by an extra electrical impulse arising from the heart’s lower left chamber or ventricle. As this disrupts regular heart beats, you may feel like your heart is fluttering or experience abnormally strong beats.
The cause is idiopathic or unknown; PVCs can happen in a healthy person of any age with a normal heart. They can also occur in patients with underlying cardiac disease or who have previously had a heart operation.
Other potential factors include too much caffeine, electrolyte imbalances, lack of sleep, or excess use of alcohol, tobacco or drugs.
Most incidences are isolated and are usually not a cause for concern. But How cautions that having a “15% PVC burden” is considered excessive and could result in left ventricular dysfunction.
If the average human heart beats about 100,000 times a day, this equates to having 15,000 instances of arrhythmia a day.
The first step in diagnosing PVCs is to do an ECG. A physician may also recommend a Holter monitor that will record a person’s heartbeats over 24 hours.
In some cases, doctors may request a supervised exercise stress test if symptoms are found to be associated with exertion, or an echocardiography to evaluate heart structure and function.
Treatment depends upon the PVC burden, symptoms, and presence of heart dysfunction. For infrequent occurrences, management is usually conservative. However, if PVCs are often and patients are symptomatic, medication might be recommended.
For those who do not respond well to medicine, a catheter ablation – which involves passing thin, flexible tubes through the blood vessels to the heart – might be necessary. This procedure is done by electrophysiologists, cardiologists who sub-specialise in heart rhythm diseases.
The detection of arrhythmia should lead to a detailed assessment of your heart. The good news is, PVCs are potentially curable if managed early and appropriately, leaving you to reserve those heart flutters for your one and only.