The Electrocardiographic Footprints of Ventricular Ectopy

Introduction

The term ectopic means “out of place” or “abnormal position” and, in relation to the heart, refers to an early or premature heartbeat, whose origin is from a focus other than the sinus node. Ventricular ectopics originate from an irritable focus within the ventricles and clinically they may be asymptomatic or described by the patient as an “extra” beat, “missed” beat or irregular pulse. Patients with frequent ventricular ectopy may describe a range of other symptoms. The term ectopy is synonymous with ectopic, but it also helps identify combinations of ectopics, such as ventricular bigeminy or couplets.

Key words

Ventricular ectopic, premature ventricular complex, electrocardiography

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Conclusion

Ventricular ectopics can be generated from irritable foci anywhere in the ventricles, although most arise from characteristic sites of anatomic heterogeneity. They increase in frequency with age and are generally benign, unless there is underlying heart disease. The ECG footprints of ventricular ectopy are a broad (.110 ms) premature ventricular complex (QRS wave) with no preceding P wave or evidence of AV conduction, a full, more than, or less than, compensatory pause and discordant QRS and T waves. Ventricular ectopics may occur in groups including bigeminy, trigeminy, couplets and triplets. Very frequent ventricular ectopics may result in a potentially reversible ectopy-mediated cardiomyopathy.