Management of benign ventricular extrasystoles
Usually, reassurance and explanation is all that is required.
Precipitating factors should be avoided (and underlying causes should be treated). For example:
- excess coffee
- excess alcohol
- smoking
- hypokalaemia
- hyperthyroidism
If a patient is symptomatic and demanding therapy, then it must be explained that benefits may not outweigh the risks.
If treatment of ventricular extrasystoles is indicated then seek specialist advice. Pharmacological agents used in the management of this condition include:
- beta-blockers
- phenytoin - of all the class I anti-arrhythmics is the only one to promote AVN conduction. Phenytoin is contraindicated in second or third degree heart block.
- amiodarone
- lignocaine (lidocaine)
- mexiletine.
Reference
- Marcus G. M., Evaluation and management of premature ventricular complexes, Circulation. (2020) 141, no. 17, 1404–1418
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