VES: extra beats in the ventricle

A heart rhythm disorder or palpitations can occur in different forms. One of these is a VES: Ventricular Extra Systole. This is an extra skip that arises from the heart chamber. The heart feels as if it is fluttering, standing still, racing or beating very fast. In fact, anything can be felt. How dangerous is this extra transshipment and does it need to be treated?

What is a VES?

The heart has a pumping function in which blood is pumped through the heart to supply all tissues with blood. The heart pumps at 50 to 80 beats per minute at rest, but during exertion this can increase to 180 beats per minute. The heart does this in a certain rhythm, but sometimes a disorder occurs in this rhythm. This is called skipping of the heart, also called extrasystole in medical language. Many people do not even feel extrasystole, but sometimes it is clearly noticeable. There are two types of extrasystoles:

  • Atrial Extra Systole (AES): extra discharge from the heart atria
  • Ventricular Extra Systole (VES): extra overflow from the heart chambers

A VES is also called a Premature Ventricular Contraction (PVC). With a VES, the problem lies in the ventricle and not in the atrium. A VES should also not be confused with a myocardial infarction/heart attack.
With a VES there is an extra stroke in the chamber. The first beat is weak, so the heart chamber has not had enough time to fill with blood. An additional second beat follows during which the heart has to pump extra to pull the blood into the chambers. The pause until the next heartbeat may take a little longer than normal. This means that a disrupted heart rhythm occurs for a while.


Most people do not feel a VES. Only when it happens more often or people start paying attention to it, does it become noticeable. A VES can be felt as palpitations, feeling the heart beating in the throat, feeling the heart beating against the chest, dizziness, shortness of breath, anxiety, panic and the feeling that the heart has stopped for a moment. In addition, the heart rate may be elevated, reaching up to 120 beats per minute at rest and up to 200 beats per minute during light exertion.
The above symptoms are the most common complaints for which immediate intervention is not necessary. If more complaints occur, it is advisable to contact a doctor:

  • Swollen calves/ankles (edema)
  • Nausea and/or vomiting
  • Pain in the stomach area
  • Chest pain, sometimes radiating to the left shoulder/arm and jaw
  • Shortness of breath and fatigue

If these symptoms occur simultaneously with palpitations, a doctor should be contacted as soon as possible. Calling the emergency line (Netherlands: 112, Belgium: 100 or 112) is always recommended in these types of situations.

VES often innocent

Palpitations such as VES are often innocent in nature. Often, but not always. Sometimes there is an underlying disease such as a thyroid disorder, anemia, fever, inflammation, a sports heart, long-term stress or panic attacks. Just as often, no underlying cause is found at all. Although more and more is possible in the medical world, many cardiologists (heart specialists) are still puzzled by the origins of heart rhythm disorders. Many people simply grow old with palpitations. Triggering factors include drinking coffee, alcohol consumption, certain spices and foods (E621), little sleep, a lot of exercise (endurance sports), stress and fever.

When to have it examined?

You do not need to see a doctor for a single VES. It is claimed that three VES in a row is reason for a visit to the doctor, but this is not always necessary. After all, many people suffer from a VES, sometimes three in a row, without realizing it. Only when other symptoms or complaints occur is there a reason to have the heart examined further:

  • When VESs occur so often that they hinder daily life
  • When VESs do not appear to decrease at rest
  • When fluid is retained, recognizable by weight gain in a short time, swollen ankles or a cough / tickly cough
  • For chest pain or fatigue
  • More than 10 VESs after heart surgery
  • When there is concern about the VESs

An examination consists of measuring blood pressure, the oxygen level in the blood and making an electrocardiogram (ECG). The blood is also tested. If nothing is found here and the VESs remain present, a cycling test will follow to determine whether the heart muscle is receiving sufficient oxygen. Making an ultrasound of the heart echocardiography) (provides more clarity about the functioning of the heart and blood flow. The patient may also be given a Holter for 24 to 48 hours. This is a portable box that continuously monitors the electrical activity of the heart. In this way, irregularities of the heart can be captured that were not clearly visible on a normal ECG.

Treatment of cardiac arrhythmias

If cardiac arrhythmias occur frequently, the risk of developing blood clots increases. A blood clot can ultimately cause a life-threatening brain or heart attack. For this reason, the treatment of serious arrhythmias such as VESs consists of administering blood thinners and/or medications that stabilize the heart rhythm. A heart rhythm disorder is sometimes a warning sign of a more serious heart condition. After investigation, this will be treated.

read more

  • Heart skips a beat, cause and effect
  • Skipping of the heart
  • Feeling the heart beating in your throat or neck
  • Heart and vascular disease
  • Heart film or ECG
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