Ventricular ectopy (VE) in the absence of organic heart disease is most often a benign condition that requires no treatment. Diagnostic evaluation should be aimed at assessing the frequency and complexity of VE, correlating symptoms to ventricular arrhythmias, and uncovering underlying heart disease when it is present. Ambulatory Hotter monitoring is more sensitive than exercise stress testing for detecting VE, but the two procedures are complementary. The decision to treat should be based on the situation in which VE occurs, tempered by the knowledge that antiarrhythmic agents are associated with significant side effects with long-term use and that they may paradoxically aggravate the underlying arrhythmia in some patients. Partial suppression of VE and maintenance of therapeutic serum drug levels is a more appropriate goal of treatment than total PVC suppression.
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