P waves do not precede QRS complexes.
Retrograde P waves may be present.
QRS complex is premature and wide.
ST segment and T wave are directed opposite the major QRS deflection.
Many PVCs have a fixed coupling interval from the preceding sinus beat and many PVCs are conducted into the atria, thus producing a retrograde P Wave.
Most PVCs do not affect the sinus node, so there is usually a fully compensatory post-ectopic pause, or the PVC may be interpolated between 2 sinus beats.

3 or more PVCs in a row = non-sustained ventricular tachycardia.


ECG Findings with PVC

Beats Mimicking PVCs


Physical exam


Acute Treatment

  1. General measures
  2. Treat underlying disease process
  3. Antiarrhythmics if clinical scenario indicates
    (Usually symptomatic or complex ectopy)
  4. If antiarrhythmic successful, follow with continuous infusion

Non-Emergent Treatment

*Treatment indicated only for symptomatic patients
*Treatment suggested for Lown class 3-5
  1. Treat underlying cause
  2. Patients with no known heart disease
  3. Patients with known heart disease
  4. Beta-blockers also indicated for:
  5. Other treatments


  1. Admit to monitored bed if
  2. May discharge home if incidental finding, no medical distress