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Ventricular Bigeminy


Presentation

  • Abstract A 65-year old male originally presented with repetitive ventricular bigeminal sequences demonstrating progressive prolongation of successive coupling intervals suggesting Wenckeback-type exit block.[ncbi.nlm.nih.gov]
  • The distributional pattern of sinus conducted beats in the present case conforms to a formula defining this unusual disorder of rhythm, while the appearance of manifest ectopic beats follows the rule of bigeminy.[ncbi.nlm.nih.gov]
  • Abstract A 31-year-old primiparous, healthy woman presented for emergency caesarean section. Following the siting of a spinal anaesthetic, seconds after starting a phenylephrine infusion, she developed ventricular bigeminy.[ncbi.nlm.nih.gov]
  • Abstract This presentation reflects a case of atypical concealed bigeminy, where some interectopic intervals contain even numbers of sinus beats. Exceptions to the rule of concealed bigeminy only occur during slowing of the sinus node.[ncbi.nlm.nih.gov]
  • Pulses were initially present and cardioversion was performed. Sinus rhythm resumed briefly but again gave way to VT, this time without pulses.[thejarvik7.wordpress.com]
Cheyne-Stokes Respiration
  • Provocation of ventricular ectopy by cheyne-stokes respiration in patients with heart failure. Sleep 2004;27:1337-43. 4. Oppenheimer S. Cerebrogenic cardiac arrhythmias: Cortical lateralization and clinical significance. Clin Auton Res 2006;16:6-11.[neurologyindia.com]
Vomiting
  • There was transient episode of nausea, vomiting, hypotension and tachycardia. The ECG showed infrequent ventricular ectopics that progressed to ventricular bigeminy and persisted even after the vital signs normalized.[ncbi.nlm.nih.gov]
Heart Disease
  • Abstract Incessant monomorphic ventricular bigeminy was studied in a young patient with no organic heart disease. The arrhythmia could not be controlled by drug therapy.[ncbi.nlm.nih.gov]
  • Cardiac causes like acute and chronic ischemic heart disease, cardiomyopathy, valvular heart disease, mitral valve prolapse can cause ventricular ectopic.[neurologyindia.com]
  • Patients with no ischaemic heart disease or cardiomyopathy have an excellent prognosis. Ventricular extrasystoles after myocardial infarction are associated with increased mortality. They may be the presenting feature of viral myocarditis.[gpnotebook.co.uk]
  • It is important to determine whether underlying structural heart disease is present and left ventricular function is impaired.[karnatakaanaesthj.org]
Skipped Beats
  • Usually benign: Premature or "skipped" beats frome the bottom chambers of the heart are common; they sometimes occur in fixed patterns. When every other beat is a premature beat, it's called ventricular bigeminy.[healthtap.com]
  • A few weeks ago I started having irreg., skipped beats all the time.[medhelp.org]
  • VPBs may be experienced as missed or skipped beats; the VPB itself is not sensed but rather the following augmented sinus beat.[merckmanuals.com]
  • Many patients describe them as skipped beats, because when they check their pulse, they don’t feel anything for a moment. However, your heart is not actually skipping or missing a beat.[equimedcorp.com]
Irregular Heart Rhythm
  • Ventricular Arrhythmias Premature ventricular contractions (PVCs) are the most common cause of irregular heart rhythms.[my.clevelandclinic.org]
  • A similar observation between cough and irregular heart rhythm was reported by Odeh and Oliven 9 ; however, they identified atrial premature complexes, and not PVCs, as factors inducing chronic cough.[erj.ersjournals.com]
Palpitations with Skipped Beats
  • When a PVC occurs as a single premature beat, patients may describe the feeling as a "palpitation" or "skipped beat." The beat following the PVC can be strong enough to cause pain or discomfort in the chest.[my.clevelandclinic.org]
Redness of Eye
  • However, he again developed ventricular bigeminy, chest pain and redness of eyes after the injection of amoxicillin clavunate, but the severity was more intense so it was treated with β blockers and amiodarone.[degruyter.com]
Hot Flushes
  • For people with neuroses at this point, the characteristic hot flushes, lack of air, weakness, sense of fear. When possible organic arrhythmias syncope, dizziness, angina.[vascular.vsebolezni.com]
Dystonia
  • The causes of the disease Trigger arrythmia can the various organic lesions of the cardiovascular system: Angina, cardiosclerosis, heart attacks; Heart disease; Myocarditis, cardiomyopathy, myocardiodystrophy; Vegetative-vascular dystonia.[vascular.vsebolezni.com]

Workup

  • […] combined spinal–epidural anaesthesia, where giving a small dose of intrathecal local anaesthetic followed by epidural drugs is an effective management strategy. [5] The aim of submitting this case report was to emphasise the fact that after adequate workup[ijaweb.org]
Wide QRS Complex
  • The signal that originated in the ventricle can be distinguished from a normal signal by its wide QRS complex and lack of a P wave. An isolated incidence of ventricular bigeminy is likely harmless.[wisegeek.com]
  • Depending on the etiology, onset of ventricular tachycardia can be paroxysmal (sudden) or nonparoxysmal, its wide QRS complexes can be uniform or polymorphic, and the ventricular beating may be independent of the atrial beating (AV dissociation).[ncbi.nlm.nih.gov]
  • Look for a wide QRS complex, equal or greater than 0.12 sec. The QRS complex shape can be bizarre. The P wave will be absent. Premature Ventricular Complex - Bigeminy Premature Ventricular Complex - Trigeminy Premature Vent.[ekg.academy]
  • Diagnosis of ventricular premature beats is by ECG showing a wide QRS complex without a preceding P wave, typically followed by a fully compensatory pause.[merckmanuals.com]

Treatment

  • In addition to prevention of rupture of the diverticulum and thrombus formation, treatment of combined ventricular tachycardia is thought to be an indication for resection of the diverticulum.[ncbi.nlm.nih.gov]
  • We recommend that if there is associated LV dysfunction and a causal link to frequent PVCs then suppression with radiofrequency ablation is a safe and effective treatment strategy.[ncbi.nlm.nih.gov]
  • Thus surgical intervention is an effective method for the treatment of patients with symptomatic, drug-resistant ventricular allorhythmias.[ncbi.nlm.nih.gov]
  • She was administered to the Neurology Department for scheduled initiation of apomorphine treatment.[e-jmd.org]
  • Consider the causes, manifestations and treatment methods of the disease.[vascular.vsebolezni.com]

Prognosis

  • Patients with no ischaemic heart disease or cardiomyopathy have an excellent prognosis. Ventricular extrasystoles after myocardial infarction are associated with increased mortality. They may be the presenting feature of viral myocarditis.[gpnotebook.co.uk]
  • The electrocardiogram in ST elevation acute myocardial infarction: correlation with coronary anatomy and prognosis. Postgrad. Med. J. 2003;79;490-504. doi:10.1136/pmj.79.935.490 Wang, K., et al. 1976.[thejarvik7.wordpress.com]
  • Presence of heart disease should be sought and, if absent, indicates good prognosis in patients with PVCs.[escardio.org]
  • The importance of VPBs for prognosis is controversial. A study by Abdalla et. al Kennedy HL, Whitlock JA, Sprague MK, Kennedy LJ, Buckingham TA, and Goldberg RJ.[en.ecgpedia.org]

Etiology

  • The constant interval between the sinus beat and PVC suggests a reentrant etiology rather than spontaneous automaticity of the ventricle.[ecg-educator.blogspot.com]
  • In addition, the arrhythmia canto be caused by the body's reaction to disease processes: Hyperthyroidism; Tumors of various etiology; Osteochondrosis of the cervical spine; Allergies; Pathology of the stomach, diaphragmatic hernia, tuberculosis; Chronic[vascular.vsebolezni.com]
  • Depending on the etiology, onset of ventricular tachycardia can be paroxysmal (sudden) or nonparoxysmal, its wide QRS complexes can be uniform or polymorphic, and the ventricular beating may be independent of the atrial beating (AV dissociation).[ncbi.nlm.nih.gov]
  • Left ventricular ejection fraction was 20% and the etiology of the cardiomyopathy was presumed to be secondary to viral infection. He developed persistent atrial fibrillation (AF).[innovationsincrm.com]
  • They are organised into groups, and further divided into clinical, etiological or histopathological sub-types.[orpha.net]

Epidemiology

  • Epidemiology [ 1 ] Both atrial and ventricular extrasystoles are common at all ages. Atrial extrasystoles These are common in healthy people with normal hearts. There are often seen on 24-hour Holter monitoring in over 60% of healthy adults.[patient.info]
  • Some epidemiological data exist with an association between PVCs activity with caffeine intake, but experimental human studies have not produced consistent results to establish this link.[escardio.org]
Sex distribution
Age distribution

Pathophysiology

  • Keywords Ablation cardiology coronary artery disease electrocardiogram (ECG) electrophysiology heart heart rate pathophysiology physiology Editors and affiliations M. Ali Oto 1 1.[link.springer.com]
  • Other forms of abnormal beats include PAC , escape beats and parasystole . [1] Classification Atrial bigeminy Junctional bigeminy Ventricular bigeminy Concealed bigeminy Escape capture bigeminy [2] Pathophysiology Several mechanisms can be involved in[wikidoc.org]
  • This review investigates the correlation between MVP and SCD, the understanding of the pathophysiology, the strategies for detecting those at risk and treatment options...[read.qxmd.com]

Prevention

  • In addition to prevention of rupture of the diverticulum and thrombus formation, treatment of combined ventricular tachycardia is thought to be an indication for resection of the diverticulum.[ncbi.nlm.nih.gov]
  • The patient's critical condition prevented our determining the effect of altering parasympathetic activity, but our observations led us to believe that the relationship between the occurrence of hiccups and the disappearance of ventricular extrasystoles[ncbi.nlm.nih.gov]
  • DDDR pacing following implantation of an atrial lead prevented further ventricular tachyarrhythmias.[ncbi.nlm.nih.gov]
  • The transaortic approach can be considered as a new and important surgical option for endocardial mapping and cryocoagulation which prevents the damaging effects of a left ventriculotomy.[ncbi.nlm.nih.gov]
  • In conclusion, thorough history, clinical examination, and judicious use of antiarrhythmic agents recommended during pregnancy can prevent an asymptomatic ventricular ectopy transforming into a fatal arrhythmia in managing a case of ventricular bigeminy[karnatakaanaesthj.org]

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