Bigeminal rhythm: Difference between revisions
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==Overview== | ==Overview== | ||
Bigeminy is a descriptor for a [[heart]] [[cardiac arrhythmia|arrhythmia]] in which abnormal heart beats occur every other concurrent beat. The abnormal heart beat can originate from the [[atrium]], [[AV node]] or the [[ventricle]]. A typical example is bigeminal rhythm resulting from premature ventricular beats, also known as a [[premature ventricular contraction|premature ventricular contractions/complexes]] (PVC). Following the PVC there is a pause and then the normal beat returns, only to be followed by another PVC. The continuation of this pairing of beats is an example of bigeminy. | |||
==Classification== | ==Classification== | ||
Revision as of 15:15, 23 August 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Synonyms and keywords: Bigeminy, bigeminal beat
Overview
Bigeminy is a descriptor for a heart arrhythmia in which abnormal heart beats occur every other concurrent beat. The abnormal heart beat can originate from the atrium, AV node or the ventricle. A typical example is bigeminal rhythm resulting from premature ventricular beats, also known as a premature ventricular contractions/complexes (PVC). Following the PVC there is a pause and then the normal beat returns, only to be followed by another PVC. The continuation of this pairing of beats is an example of bigeminy.
Classification
- Atrial bigeminy
- Junctional bigeminy
- Ventricular bigeminy
- Concealed bigeminy
- Escape capture bigeminy
Pathophysiology
Differential Diagnosis
| Bigeminal premature ventricular contractions | Normal, PVC, Normal, PVC... |
| Trigeminal premature ventricular contractions | Normal, Normal, PVC, Normal, Normal, PVC... |
| Quadrageminal premature ventricular contractions | Normal, Normal, Normal, PVC; Normal, Normal, Normal, PVC... |
| Occasional escape complexes | Normal, Normal, Normal, Normal, Pause, Escape... |
| Bigeminal Couplets | Normal, Normal, PVC, PVC, Normal, Normal, PVC, PVC... |
| NS-VT | Normal, Normal, PVC, PVC, PVC, PVC, Normal, Normal, PVC... |
Diagnosis
ECG
Shown below is an EKG depicting atrial bigeminy. The EKG shows a regularly irregular rhythm at a rate of about 75/minute. There are two P wave morphologies best seen in lead V1.
Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page
Shown below is an EKG depicting bigeminy. The pacemaker is an atrial pacer set at 30/min. Note the marker channel documenting atrial pacing and then sensing of the QRS in the refractory period of the pacemaker. The paced atrial beats seem to stimulate a normal sinus beat and hence create the bigeminal rhythm.
Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page