Wrap Up

• This patient´s physical examination was normal except for "skipped beats".
• Her ECG in the office showed many ventricular premature beats but was otherwise normal. She was able to feel several of the prematures.
• Ambulatory monitoring seemed unnecessary but she did have a stress echo to allay her fears about coronary disease.
• Premature beats and ventricular premature beats in particular, are the most common arrhythmias in humans.
• They occur and often recur persistently (for years) in people with no evidence of heart disease whatsoever.
• Almost everyone will show some VPBs or SVPBs on a 24 hour ambulatory ECG sample.
• Treatment of premature beats should be avoided. When symptoms are excessive or when the beats occur frequently, referral to cardiology is usually the best approach.