Ventricular bigemia is a characteristic recording of the ECG curve in which normal beats alternate with ventricular ones. Do you know what is ventricular bigeminy, is it dangerous and how is it treated?

Contents:

  1. Ventricular bigeminy: what is it?
  2. Ventricular bigeminy: causes
  3. Ventricular bigeminy: symptoms
  4. Ventricular bigemia: diagnosis and treatment

Ventricular bigeminy: what is it?

Ventricular bigeminyare cardiac arrhythmias with a very characteristic system of additional stimulations in the ECG examination: ventricular agitation appears after normal sinus stimulation. Ventricular bigemia is not a disease in itself, but it may indicate its occurrence, so if it is found, more detailed cardiological diagnostics is often required.

The concept of ventricular bigemia is inextricably linked with the heart's conductive system and the phenomenon known as additional ventricular beats. The conductive system is a complex structure built into the heart muscle that produces and conducts impulses to keep the heart working properly. Once generated in the sinus node, the stimulus runs through the atria, stimulating them to contract. It then passes through the atrioventricular node, the bundle of His and its branches, and Purkinje fibers into the ventricles, which eventually also become activated and contracted. The proper functioning of the stimulus system ensures the proper work of the heart, both in terms of its frequency - e.g. acceleration of the heart rate during exercise, and the proper spread of stimuli.

Ventricular extra beats are abnormal, extra contractions of the heart disrupting its rhythm. The conductive system is not involved in their formation, and the source is the muscle of the heart chambers. Therefore, they belong to the ventricular arrhythmias, i.e. those occurring below the His bundle. Additional ventricular stimuli are generated as a result of disturbances in electrical mechanisms, the presence of ectopic foci - places where the electrical impulse "loops" causing subsequent activation and contraction of the ventricles. Such arousal is generally harmless and occurs in most people. However, they can become dangerous if they cause severe symptoms, are very large or appearin people with severe heart disease. We talk about ventricular bigeminia when additional ventricular stimuli occur after each normal sinus stimulation. So this is not a different phenomenon, but a description of a specific, rhythmic appearance of ventricular beats.

Ventricular bigeminy: causes

Additional ventricular arousal often occurs for no reason, this is less common in bigeminy - it is much more likely to indicate heart disease. Factors increasing the frequency of these arrhythmias include: nervous system stimulation, endocrine disorders, heart ischemia, medications and electrolyte disturbances, but also: family predisposition, stimulants or thyroid diseases.

Ventricular bigeminy: symptoms

Ventricular arrhythmias such as accessory beats are usually asymptomatic. Bigeminy, however, more often causes various types of ailments: palpitations and irregular heartbeat, the feeling of "the heart running out to the throat or stomach", stinging in the precordial area, or general weakness.

Ventricular bigemia: diagnosis and treatment

The diagnosis of ventricular bigemia can only be confirmed on the basis of an ECG, and this test is the key to suspecting this arrhythmia. The image shows dilated QRS complexes after normal - narrow ones. It happens that the examination is performed at a time of well-being and it is not possible to record bigeminia, in such cases 24-hour Holter ECG monitoring can be performed, especially when arrhythmia attacks are frequent. This allows you to determine the number of additional beats, their frequency of occurrence, and any other arrhythmias. Event recorders are very rarely implanted for diagnostic purposes.

If the nature, frequency or symptoms of ventricular bigemia induce further diagnosis, the following is performed:

  • laboratory tests to look for non-cardiac causes of arrhythmia,
  • echocardiography to accurately assess the anatomy of the heart,
  • stress test and possibly coronary angiography if ischemic heart disease is suspected,
  • an electrophysiological test that allows you to accurately assess the arrhythmia and the area in the heart responsible for it

Treatment is based on the treatment of the causes of: electrolyte disturbances, thyroid disease, ischemic heart disease, heart failure or others, if any. It is also important to quit smoking and reduce the amount of alcohol and coffee you consume.

Other therapeutic options are antiarrhythmic drugs, and if they are ineffective - ablation treatment, i.e.destroying the places in the heart responsible for the occurrence of bigeminy.

Treatment methods depend primarily on the cause, symptoms, and he alth hazards that may arise from the arrhythmia. This danger is determined individually for each individual on the basis of, among other things, the presence of heart diseases and the frequency of arrhythmias.

Bow. Maciej GrymuzaA graduate of the Faculty of Medicine at the Medical University of K. Marcinkowski in Poznań. He graduated from university with an over good result. Currently, he is a doctor in the field of cardiology and a doctoral student. He is particularly interested in invasive cardiology and implantable devices (stimulators).

Category:

Cardiology