- Ventricular premature complexes can be preceded by a sinus P- but this is not conducted.
- The diagnosis can never be made with full certainty from the surface ECG- it may be a supraventricular beat.
- Pauses-
- Compensatory- usual.
- Non-compensatory- if retrograde conduction.
- No pause- interpolated.
- Postponed compensatory- first degree block in next beat causes complete heart block in the next.
- Ventricular premature complexes may be narrow if-
- Arising high in the IVS
- Fusion of two ventricular premature complexes or one ventricular premature complex and a supraventricular aberrant beat.
- Frequent ventricular premature complexes can cause heart failure!
- Tea, coffee or alcohol may be the cause of ventricular premature complexes.
- The ventricular premature complex may have a first heart sound, without a second heart sound.
- The electrolyte imbalance which causes ventricular premature complexes is hypokalemia.
- The drug of choice to acutely suppress ventricular premature complexes is lignocaine. If it does not work, try procainamide and then propranolol or magnesium
- Ventricular premature complexes are more in males.