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Bigeminy - Symptoms, Causes, Diagnosis, and Treatment

Published on Jan 17, 2023 and last reviewed on May 22, 2023   -  5 min read


Bigeminy is an abnormal heart rhythm in which the heart beats irregularly. Learn more in the article.


In bigeminal conditions, an irregular heartbeat is followed by normal heartbeats. This occurs both in males and females. This is a rare condition. This is not a severe condition and does not require treatment in most cases, and only if the symptoms are more, there is a need for medications.

What Is Bigeminy?

  • A heart functioning normally has a regular rhythm, with both upper and lower chambers that beat in unison and a recognizable pattern. There is a pause following every heartbeat, followed by a predicted heartbeat, a pause, and so on.

  • However, when they have bigeminy, each regular heartbeat is followed by one that happens too quickly. There are both long and short beats in it. Twins are two sets of two beats each.

  • If those early heartbeats come from the ventricles, the heart's lower chambers, they are known as premature ventricular contractions (PVCs). If they start in the atria, the heart's upper chambers, they are known as premature atrial contractions (PACs).

  • The right ventricle supplies the blood to the lungs with each heartbeat so that carbon dioxide can convert to oxygen in the lungs.

  • Blood is circulated throughout the body via the left ventricle through the aorta. In preparation for the next heartbeat, the atria fill with blood and pump it into the ventricles. The ventricles receive blood.

  • If an early contraction happens before the ventricles have filled with blood, they experience a skipped beat. Due to little or no blood being pumped out of the heart, a premature beat may feel different from a regular heartbeat. The premature beat will be more obvious if the ventricles have had time to fill with blood. They will consequently feel as though their hearts are beating more quickly than usual.

  • PACs and PVCs are widely used and frequently safe. In addition, they can occasionally have PACs or PVCs without developing bigeminy. Bigeminy, however, may indicate future cardiac problems if early contractions are a persistent issue.

What Are the Symptoms of the Bigeminy Condition?

Bigeminy symptoms are as follows:

They might not even be aware that they are having early contractions. If they experience symptoms, they will experience variations in their typical heart rate. These could be slight or cause them to feel their heart pump. A person with bigeminy could feel like their heart is pounding but missing a beat.

What Are the Causative Factors of Bigeminy?

Only occasionally are the bigeminy causes evident. Problems with the heart's electrical system, which regulates when and how strongly the heart beats, may be caused by heart disease or excessive blood pressure. Premature contractions can also be triggered by:

  • Alcohol.

  • Caffeine.

  • Chewing tobacco.

  • Asthma medications and other medications.

  • Chemical imbalances in the body.

  • Anxiety.

  • Exercise.

What Is the Diagnosis of Bigeminy?

  • An ECG is a preliminary test to identify bigeminy (ECG). The doctor will apply electronic sensors to the chest for an EKG. These sensors capture the heart's electrical activity. The recorded information can pinpoint the cause of an atypical heart rhythm.

  • They might also go through an exercise stress test. They use a stationary bike or treadmill connected to the EKG machine for this test. The doctor might use this to assess the bigeminy's severity.

  • Premature contractions are not dangerous if they stop during exercise. However, it may indicate a more significant heart rhythm disorder if exercise causes additional heartbeats. An arrhythmia is another term for an irregular heartbeat.

  • One drawback of an EKG is that it is likely not to detect them during the test if they occasionally experience premature contractions. When they undergo the test, the heart can operate normally. If this occurs, the doctor can advise them to wear a Holter monitor or other 24-hour monitor to catch the early contractions whenever they come.

What Is the Treatment of Bigeminy?

They might not require bigeminy treatment if they do not have a cardiac condition and show no symptoms at all.

  • Beta-Blockers:

If the patient requires medical attention, beta-blockers, which help to relax the heart and reduce blood pressure, may be the first line of treatment. In addition, patients may take calcium channel blockers to lower blood pressure and lessen the stress on their hearts, as well as antiarrhythmic medications to assist their hearts in returning to a healthy, regular beat.

  • Catheter Ablation:

If the area of the heart causing the rhythm issue can be located in severe cases of bigeminy, catheter ablation can be required. A slender flexible tube called a catheter is used to transport blood from a blood vessel in the leg to the heart, delivering a small electrical charge to the tissue and creating an electrical disturbance. Since the charge destroys the tissue, the aberrant contractions frequently stop.

Catheter ablation, though, is not always effective. Therefore, to treat the cardiac issue, it may occasionally be necessary to make more than one effort or to have surgery.

Is the Bigeminy Condition Severe and Life-Threatening?

At some stage in life, most people have premature cardiac contractions without any injury or consequences. Children and teenagers are particularly susceptible to harmless PVCs or PACs. Bigeminy symptoms that are apparent and persistent as opposed to moderate and rare raise far more serious health issues.

Bigeminy can increase the risk of arrhythmia like atrial fibrillation, in which the top and lower heart chambers do not beat in unison.

Blood may collect in the atria and form a clot when this occurs. The risk of a deadly stroke increases if the blood clot ascends from the heart to the brain.

The extra burden on the heart by the extra beats may cause cardiac hypertrophy and even heart failure.

How to Prevent Bigeminy Condition?

Bigeminy frequently has an unclear cause, making prevention challenging. However, bigeminy is strongly correlated with heart disease. So ensure their heart is healthy.

  • Adopt a heart-healthy diet (reduced in salt and fat).

  • Regular exercise.

  • Give up smoking.

  • Control the levels of blood sugar, cholesterol, and blood pressure.

  • Bigeminy might become active during an adrenaline spike. Avoiding substances like caffeine and cigarettes, which can occasionally cause the release of adrenaline, may assist in maintaining a steady heartbeat. Keeping track of any additional triggers causing contractions is also helpful.

  • It is advised that people manage their stress through meditation and other relaxation techniques because stress and anxiety can potentially cause issues with the heartbeat. Regardless of their heart condition, learning to manage their stress can significantly impact their health.


The bigeminy condition is not life-threatening and serious in most cases. But there is a need to practice a healthy lifestyle and consume a well-balanced meal. In severe cases, there is a need for surgery. Sometimes bigeminy has unclear origins. The heart's electrical system, which regulates when and how strongly the heart beats, may experience issues due to heart disease or elevated blood pressure. Hence, there is a need for correct diagnosis and immediate treatment.

Last reviewed at:
22 May 2023  -  5 min read




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