Hoffmann, "Suppression of concealed pulmonary vein bigeminy
by atrial pacing in a patients with paroxysmal atrial fibrillation," Pacing and Clinical Electrophysiology, vol.
Luckily there was no incidence of ventricular ectopic or bigeminy
in that period.
The rhythm classification categories and relevant MIT-BIH symbols are normal sinus rhythm N, ventricular premature systole VPS, ventricular bigeminy
B, ventricular trigeminy T, ventricular couplet C, ventricular tachycardia VT, ventricular flutter/fibrillation VFL, and 2nd degree heart block BII.
An exercise stress test revealed premature atrial contractions (PACs) in patterns of bigeminy
and quadrigeminy,13 PACs per minute, an ectopic atrial pacemaker, and inappropriate blood pressure response to exercise.
He continued to have runs of bigeminy
, but no more VT was noted during his hospital stay.
In several case reports, ECG changes during the vasovagal reflex among patients with needle phobia have included sinus arrhythmia, premature atrial contractions, premature junctional contractions, unifocal and multifocal premature ventricular contractions, bigeminy
, first- and second-degree block, changes in P waves, ST waves, and T waves, sinus bradycardia, sinus tachycardia, ventricular tachycardia, ventricular fibrillation, and asystole.(1)(2)(5)(26)(27)(28)(37) Presumably, these ECG changes are secondary to vagal influence on the sinoatrial and atrioventricular nodes, and perhaps also to the antagonism between the activated sympathetic and parasympathetic systems on the heart.(27)
Previous reports have shown that catheter ablation could be an alternative for the treatment of atrial bigeminy
or AT in drug-resistant symptomatic patients.[sup], A study has reported RAA as the site of focal AT in 3.8% of the cases.[sup] However, there are no studies about the origins of atrial bigeminy
The 12 leads ECG on admission, showed ventricular bigeminy
followed by an episode of polymorphic ventricular tachycardia (VT)--torsades de pointes (TdP) (Figure 2).
The pattern of atrial bigeminy
seen in the Figure also could be produced by an automatic focus in the A-V junction or low in the atria.
The ECG continued to show runs of VT, pulseless electrical activity and bigeminy
Excluded were 110 subjects (16.4%) with problematic heart rate measurements, including atrial fibrillation, atrial bigeminy
or trigeminy, pacemakers, irregular rhythm, irregular sinus rhythm, frequent ventricular ectopic activity, ventricular bigeminy
, multi-focal atrial tachycardia, or measurement time < 3.5 min.
Once the dopamine drip was initiated, her VT episodes appeared more frequent and she had more bigeminy