When you start an exercise program, you want to make sure your heart is healthy.

If you’re one of the many people who experience premature ventricular contractions (PVCs) during and after exercise, you may wonder whether it’s safe for you to exercise with PVCs.

This article breaks down everything you need to know about the safety of exercising with PVCs. If you have PVCs, this info will kick-start your journey toward minimizing the risk and maximizing the rewards of regular exercise.

Note that you should always consult a healthcare professional before beginning any exercise program.

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PVCs are a type of abnormal heartbeat that originates in the ventricles, disrupting the regular rhythm and causing the sensation of either a skipped beat or palpitations. They are common and usually harmless, and many people who experience them have no symptoms (1).

Your heart is made up of two atria and two ventricles.

Typically, the signal for your heartbeat starts in the right atrium in the sinoatrial node and travels to both the left and right ventricles, allowing your heart to coordinate its rhythm in your heartbeat.

But during a PVC, the opposite happens, and the contraction starts prematurely in the Purkinje network of the ventricles (2).

When this happens, you may not experience any symptoms, or you might notice the irregular rhythm. The irregularity commonly creates a sensation that your heart has skipped a beat or jumped in your chest, followed by a sensation of fluttering in your chest (1).

If the contraction is strong enough, it may leave you feeling lightheaded or anxious and possibly cause some chest discomfort.

Still, most PVCs feel like heart palpitations and are benign, meaning they do not need treatment. Most people will experience them at some point in their lives (1).

However, if the PVCs are prolonged or frequent, if you get dizzy or lose consciousness, or if you have any underlying heart disease risks, you should consult a healthcare professional. In these cases, PVCs can be serious.

Summary

PVCs are common and cause an abnormal heartbeat. They are typically benign but may be more dangerous for those with underlying heart conditions.

In most cases, there is no known cause of PVCs.

Researchers have suggested that too much caffeine, high anxiety, or irregularities in electrolyte balance could affect PVCs, with lower levels of magnesium or potassium and high levels of calcium in the body being of particular importance (1).

Getting too little sleep, drinking alcohol, and using stimulants or other substances can further worsen PVCs.

Likewise, hypoxia (not enough oxygen in the blood), exercise, and certain medications can induce PVCs (3).

If you’re having symptoms of PVCs, it’s a good idea to check your overall stress levels. By reducing stress, you may be able to reduce the frequency of PVCs (1).

Summary

The causes of PVCs are not well understood, but anxiety, caffeine, and electrolyte imbalances are thought to be key factors.

Occasional PVCs are very common.

Researchers who have monitored subjects for 24–48 hours have found that 50–75% of the study population had PVCs. They have also found that the prevalence of PVCs is higher in males and increases with age, although even young children experience them (3, 4).

Research suggests that PVCs occur more frequently in those who smoke, are taller, are Black, get minimal exercise, have heart disease, or have higher blood pressure (5).

Summary

Occasional PVCs are very common, even in people who have healthy hearts. However, some factors, such as older age and smoking, are associated with a greater frequency of PVCs.

PVCs are usually considered benign unless they are frequent, but it can be difficult to decipher what classifies as “frequent.”

Some research classifies frequent PVCs as occurring in more than 20% of your heartbeats in 24 hours (6).

A healthy heart beats 86,000–144,000 times in 24 hours, so 20% of that is well over 17,000 irregular heartbeats in 24 hours (7).

Other research takes a different approach to frequent PVCs by counting how many occur in 1 hour. In this case, 30 or more PVCs per hour is considered frequent (1).

Still other research suggests a simpler way to assess your risk factor: If PVCs occur more than 12 times per day, you should seek the advice of a medical professional. Some studies have found that 12 or more PVCs per day predict a greater chance of long-term heart problems (8).

Summary

If you experience PVCs more than 30 times per hour or more than 12 times per day, you should see a doctor.

The short answer: It depends on how frequently you experience PVCs and whether the irregular contractions decrease or increase after exercise.

In some cases, exercise can decrease the frequency of PVCs. In other cases, it can induce PVCs — these are called EI-PVCs (exercise-induced premature ventricular contractions) (9).

If you are healthy, do not have heart disease, and experience occasional PVCs that do not worsen with physical activity, exercising should not present any danger.

If your PVCs are exercise-induced, they may still be harmless, but it’s important to note when they happen.

Research suggests that if EI-PVCs are common during the recovery phase of your workouts, you may be at much greater risk of cardiovascular disease and mortality than if the PVCs occur only during the workout (1, 10).

If you experience frequent PVCs, it’s a good idea to consult a healthcare professional before performing heavy exercise. There are two reasons for this.

First, frequent PVCs can indicate underlying heart disease or lead to conditions such as cardiomyopathy (11).

In the case of cardiomyopathy, research has found that the best way to prevent worsening disease is to halt intense exercise (12).

Secondly, if your PVCs are a result of low electrolyte balance, as mentioned earlier, intense exercise will only deplete electrolytes more (13).

Potassium is further depleted through sweat, and magnesium levels drop after exercise because magnesium is a necessary metabolic component that helps with muscle recovery and energy utilization (13, 14, 15, 16, 17).

If low electrolytes are causing your PVCs, you may find that supplementation helps decrease the frequency of these irregular contractions. But it’s best to consult a medical professional before beginning a supplement routine (18).

Research on this treatment method is still ongoing (19).

As always, make sure to check with a doctor if you’re having repeated PVCs and are worried about the associated risks.

Summary

Exercising with PVCs is generally considered safe, but if you have frequent PVCs that become worse during or after exercise, it’s worth getting a medical opinion.

Research suggests that EI-PVCs happen 7% of the time in healthy people and up to 54% of the time in those with cardiovascular disease (9).

While PVCs are not uncommon during exercise, the impact of exercise on the frequency of PVCs is the most important factor to note.

If you experience more frequent PVCs during or after exercise, further investigation is warranted to ensure there are no further cardiac concerns. If your PVCs are suppressed with exercise and do not increase during the recovery period, it’s likely your PVCs are benign (20).

Furthermore, while exercise may temporarily increase PVCs, some research suggests it’s a good treatment for arrhythmia in the long term (21).

In a 2015 study, researchers monitored 5,011 athletes without cardiac abnormalities during exercise using electrocardiography (22).

Of those, 331 athletes showed a reduction of arrhythmia after 3–12 months of repeated exercise and 83 of those 331 completely stopped having the abnormal heart effects (22).

Likewise, in children and teenagers with no underlying cardiac disease, exercise has proven to be a good method of suppressing PVCs (4, 22).

Summary

It’s important to note how exercise affects your PVC symptoms. If PVCs increase or worsen after exercise, it’s a good idea to seek out more tests. However, in some cases, exercise will suppress PVCs or decrease their frequency long-term.

No single type of exercise has been found to be best for people with PVCs. Much of the research on PVCs and exercise uses aerobic exercise as the parameter.

With that in mind, low intensity forms of cardiovascular exercise, such as hiking, walking, and biking, are most likely the best because they will strengthen your heart — provided they aren’t worsening your symptoms.

A strength training routine is also a good idea to balance out your program.

If you notice that higher intensity exercise — or any exercise, for that matter — increases the frequency of your PVCs, it’s a good idea to consider backing off or choosing other modalities such as yoga, Pilates, or weight training while you consult a healthcare professional.

Summary

Aerobic exercise is the most studied form of exercise in people with PVCs. A weight training routine is also worth including for comprehensive fitness.

While experts do not fully understand the causes of PVCs, stress and lifestyle factors are likely related to how frequently they occur.

If you’re concerned about the frequency of your PVCs, check with a healthcare professional for next steps. With stress testing and heart rate monitoring, they should be able to give you a path forward.

Exercising is generally safe if you only occasionally experience PVCs and they don’t worsen during or after your workouts. In fact, aerobic exercise may help reduce your symptoms in the long term.

Making an effort to reduce your stress levels, keep your heart healthy, and maintain a healthy electrolyte balance can go a long way toward reducing the frequency of PVCs in the future.