There are 6 grades of PVCs: I, II, III, IVa, IVb , and V. The first three grades are benign and do not need to be treated if the patient is hemodynamically stable and not symptomatic. Grades IVa, IVb and V require treatment, as if they are left untreated they can potentially develop into fatal rhythms such as VT and VF. A 24 hour ECG should be conducted so as to grade the severity of the patient's extrasystoles.
Grade 0 No ventricular extrasystoles/ectopics Grade I Unifocal and infrequent PVCs; <30 PVCs per hour Grade II Unifocal and frequent PVCs, ≥30 PVCs per hour Grade III Multifocal Grade IVA 2 consecutive beats (couplets) Grade IVB ≥3 consecutive beats (salvos) Grade V "R on T" phenomenom Note that >5 consecutive PVCs is considered a run of VT. This run of VT may either be sustained or non-sustained;treat as per VT. Share your views.
