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Premature ventricular contraction usually originates from an area of Ectopic focus. In this illustration ectopic area is near papillary muscles in the left ventricle. Most commonly in healthy hearts PVCs occur near right ventricular outflow tract (RVOT). A premature ventricular contraction on an EKG, marked by the arrow: Specialty: Cardiology
It is a form of cardiac arrhythmia in which ectopic foci within either ventricular or atrial myocardium, or from finer branches of the electric transduction system, cause additional beats of the heart. Some medications may worsen the phenomenon. [citation needed] Ectopic beats are considered normal and are not indicative of cardiac pathology.
Bigeminy is contrasted with couplets, which are paired abnormal beats. Groups of three abnormal beats are called triplets and are considered a brief run of non-sustained ventricular tachycardia (NSVT), and if the grouping lasts for more than 30 seconds, it is ventricular tachycardia (VT). [2]
Sinoventricular conduction is a rare form of cardiac conduction in which the sinoatrial node generates an impulse that is conducted to the atrioventricular node (AV node) in the absence of the right atrium contracting. This is the physiological proof for the presence of the internodal tracts, which have not been clearly demonstrated histologically.
SVES should be viewed in contrast to a premature ventricular contraction that has a ventricular origin and the associated QRS change. Instead of the electrical impulse beginning in the sinoatrial (SA) node and propagating to the atrioventricular (AV) node, the signal is conducted both to the ventricle and back to the SA node where the signal began.
The published report of non-sustained ventricular tachycardia during prolonged space flight [3] supports this hypothesis, in that initiation of tachycardia by a late diastolic premature ventricular contraction (PVC) is more consistent with triggered activity than it is with re-entry.
This contrasts with the pseudofusion beat wherein the pacemaker impulse does not affect the complex of the natural beat of the heart. Pseudofusion beats are normal. Rare or isolated fusion beats caused by pacemakers are normal as well, but if they occur too frequently may reduce cardiac output and so can require adjustment of the pacemaker. [3]
When there is a negative concordance, it almost always represents a life-threatening condition called ventricular tachycardia because there is no other condition that suggests any abnormal conduction from the apex of the heart to the upper parts.
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