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Ventricular premature beats

Antonis S Manolis, MD
Section Editor
Hugh Calkins, MD
Deputy Editor
Brian C Downey, MD, FACC


Ventricular premature beats (VPBs), also referred to as ventricular premature complexes, premature ventricular beats, premature ventricular complexes, or ventricular extrasystoles, are triggered from the ventricular myocardium in a variety of situations. VPBs are common and occur in a broad spectrum of the population. This includes patients without structural heart disease and those with any form of cardiac disease, independent of severity.

The prevalence, mechanisms, clinical manifestations, diagnosis, and treatment of VPBs will be presented here. A discussion of supraventricular premature beats is presented separately. (See "Supraventricular premature beats".)


Lown's grading of VPBs into six categories was initially proposed as a prognostic classification, but it has become clear over the years that this pertains only to acute myocardial infarction and ischemia and bears no prognostic relevance in other situations [1]. Prognosis relates only to the underlying structural heart disease and the degree of any left ventricular dysfunction, not to the complexity of the VPBs. Nevertheless, it has served as a descriptive reference point of communicating the complexity of ventricular ectopy. The following six grades have been included in this type of classification:

Grade 0 – No VPBs

Grade I – Unifocal and infrequent VPBs; <30 VPBs per hour

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Literature review current through: Nov 2017. | This topic last updated: Jul 24, 2017.
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