In the setting of an acute MI, PVCs indicate the underlying electrical instability of the heart. The patients are at increased risk for the development of primary ventricular fibrillation. Current work indicates that various degrees of PVCs ("warning dysrhythmias") are not reliable predictors of subsequent ventricular fibrillation.
Although it is experimentally established that electric impulses, such as PVCs, that occur during or soon after repolarization (the so-called vulnerable period) can initiate ventricular tachycardia or fibrillation, clinical studies have found that late-coupled PVCs initiate more paroxysms of ventricular tachycardia than early-coupled PVCs (R-on-T phenomenon).
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