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Bigeminy - Symptoms, Causes, Diagnosis, and Treatment

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

Medically reviewed by

Dr. Muhammad Zohaib Siddiq

Published At January 17, 2023
Reviewed AtJune 30, 2023

Introduction:

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.

Conclusion:

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.

Frequently Asked Questions

1.

Can Individuals With Bigeminy Donate Blood?

Individuals with heart rhythm disorders are usually screened carefully by blood donation centers to ensure that their condition is stable, and there are no complications to the donor or recipient of the donated blood. If an individual with bigeminy has a stable heart rhythm and is well-controlled with medication, they may be eligible to donate blood.

2.

When Is a Bigeminy Condition a Cause of Concern?

In many cases, bigeminy is not a cause for concern and does not require treatment. However, individuals with bigeminy should be evaluated by a physician so that causative factors rule out any severe conditions. Suppose bigeminy is accompanied by chest pain, shortness of breath, dizziness, or fainting. In that case, it may indicate a more serious underlying heart disorder that must be managed by a physician immediately.

3.

What Is Ventricular Bigeminy and Trigeminy?

Ventricular bigeminy and trigeminy are both types of cardiac arrhythmias that occur in the heart's ventricles. The heart beats irregularly in these arrhythmias, with premature ventricular contractions (PVCs) occurring after every second or third normal beat respectively.

4.

In Bigeminy Individuals, What Is PAC?

A "PAC" stands for "premature atrial contraction," a type of irregular heartbeat originating in atrial chambers.PACs differ from PVCs because they occur earlier than the next expected heartbeat, but a compensatory pause does not follow them. In individuals with bigeminy, PACs may occur in addition to the PVCs, leading to a rhythm in which every other heartbeat is either a PAC or a PVC. This can cause palpitations, dizziness, or other symptoms and may require treatment if it persists or worsens over time.

5.

What Are Ventricular Premature Contractions?

Ventricular premature contractions (VPCs) are abnormal heartbeats that originate in the ventricles (the lower chambers of the heart) instead of the normal electrical conduction pathway in the atria (upper chambers of the heart). VPCs can occur in various patterns, including bigeminy, trigeminy (every third beat is a VPC), and quadrigeminy (every fourth beat is a VPC).

6.

What Is the Management of the Bigeminy of Pvc?

If the bigeminy is causing symptoms such as palpitations, dizziness, or shortness of breath, the primary step is to manage medical disorders contributing to the arrhythmia. Medicines to reduce elevated blood pressure or other cardiac conditions, as well as lifestyle alterations like decreasing alcohol and limiting coffee. If the symptoms persist, medications such as beta-blockers or calcium channel blockers may slow the heart rate and reduce the frequency of PVCs. In some cases, antiarrhythmic drugs such as amiodarone or sotalol may suppress PVCs and other arrhythmias. In more severe cases, procedures such as pacemakers, defibrillator placement, or catheter ablation may be considered.

7.

What Are the Causative Factors of Decreased Blood Pressure and Bigeminy?

Decreased blood pressure, or hypotension, occurs due to various causative factors like dehydration, blood loss, heart problems, hormonal imbalances, medication side effects, and neurological conditions. Bigeminy, on the other hand, refers to a heart rhythm disorder characterized by an irregular heartbeat where every different beat is a premature contraction, which can lead to a feeling of skipped beats.

8.

What Is Meant by Atrial Bigeminy?

Atrial bigeminy is a type of arrhythmia, or irregular heartbeat, where every other heartbeat is a premature contraction originating from the atria (the upper chambers of the heart). This means the heart beats in a pattern where two heartbeats are close together, followed by a pause before the next pair of beats.

9.

How Is Ventricular Bigeminy Measured?

During an ECG, electrodes are attached to the arms, thighs, and chest skin. They detect the electrical signals generated by the heart. The ECG records these signals and visually represents the heart's electrical activity. To diagnose ventricular bigeminy, the ECG tracing will show a repeating pattern of a normal heartbeat followed by a premature ventricular contraction, with every other beat being a PVC. The presence and frequency of ventricular bigeminy can be measured by analyzing the ECG recording and counting the number of PVCs in a given period.

10.

What Is Meant by Escape Capture Bigeminy?

Escape capture bigeminy is a cardiac arrhythmia where the heart beats irregularly, alternating between a regular and premature beat. In this condition, the premature beat (or ectopic beat) originates from a lower part of the heart's electrical conduction system and disrupts the heart's normal rhythm.

11.

What Is Feta Bigeminy?

Fetal bigeminy is an abnormal heart rhythm characterized by premature ventricular contractions (PVCs) that occur every other beat. This can be detected on an electrocardiogram (ECG) and sometimes felt as palpitations or skipped heartbeats. Fetal bigeminy is typically not a serious condition on its own. Still, it can indicate underlying heart disease or electrolyte imbalances and may require further evaluation and treatment.

12.

What Is Pili Bigeminy?

Pili bigeminy is a medical term that describes a specific pattern of heart rhythm disturbance called premature ventricular contractions (PVCs). PVCs occur when the ventricles (the heart's lower chambers) contract earlier than they should, causing a brief pause in the regular heart rhythm before the next average beat. In pili bigeminy, every other heartbeat is a premature ventricular contraction, resulting in a common pattern of two normal seconds followed by one PVC.
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Dr. Muhammad Zohaib Siddiq
Dr. Muhammad Zohaib Siddiq

Cardiology

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