A 24-hours Holter recording revealed up to significant ventricular ectopic burden, many of which were bigeminy and
trigeminy in nature.
Supraventricular or atrial
trigeminy is an impulse formation disturbance characterized by a condition in which every third beat is a supraventricular premature beat (BOLTON, 1975).
SSYX had a downward trend in monomorphic, polymorphic, multifocal, paired, bigeminy, or
trigeminy VPCs and in NSVT.
The series 100 includes 23 subjects without AF, whereas the series 200 contains AF episodes and other rhythms, such as atrial and ventricular bigeminy, ventricular
trigeminy, atrial flutter, and ventricular and supraventricular tachycardia.
Ventricular ectopy was 5374, with 390 V-Runs and 680 V-Pairs, Ventricular Bigeminy events were 31 and ventricular
Trigeminy events were 6.
The episodes that can be classified include ventricular premature systole, ventricular bigeminy, ventricular
trigeminy, ventricular couplet, ventricular tachycardia, ventricular flutter/fibrillation, and 2nd degree heart block.
Ventricular cardiac rhythm impairments were identified in 5 (23.8 [+ or -] 9.5%) patients and manifested as extrasystoles, bigeminy and
trigeminy. The presence of zones of hypokinesia and akinesia was revealed in 4 (19.1 [+ or -] 8.7%) patients, that was also confirmed by trans-mural myocardial infarction identified on ECG and from the past history.
All cases demonstrated frequent runs of bigeminy,
trigeminy and/or multiple episodes of uni-/multi-focal PVC and were determined by the attending anesthesiologist to require conversion to ECG-gated shock delivery for patient safety.
of events per patient (interquartile range) Arrhythmia Mask No mask Mask No mask Dropped 2 2 1(1-1) K1-D beat VT 1 2 2 (2-2) 1(1-1) Salvo 1 2 4 (4-4) 2(1-3) Bigeminy 15 18 4(1-33) 6 (2-36) Triplet 1 0 11(11-11) 0(0-0) Couplet 9 4 2(1-5) 2(1-10) Bradycardia 20 19 52 (3-275) 89 (9-347) SVT 2 5 1(1-1) K1-D
Trigeminy 3 4 12(6-134) 10(6-230) Premature 79 77 17(3-122) 22(3-181) aberrant Isolated 52 54 3(1-16) 5(1-25) aberrant Premature 81 84 12 (3-56) 12 (3-42) normal Abbreviations: SVT, supraventricular tachycardia; VT, ventricular tachycardia.
In the largest series of overdoses cases, sinus tachycardia, ventricular
trigeminy, and junctional rhythms occurred on doses as high as 1500 mg of fluoxetine alone (23, 24).
Ambulatory cardiac monitoring showed frequent PVCs (16% of QRS complexes) with frequent
trigeminy. Symptoms worsened, and 22 days after vaccination, she was evaluated in an ED and hospitalized.
Once the dopamine drip was initiated, her VT episodes appeared more frequent and she had more bigeminy and
trigeminy. Her electrolytes on admission to the PICU were Na 139, K 4, Cl 92, HC[O.sub.3] 23, Glucose 91, Mg 2.1, and Ca 9.8.
