Q. There is ventricular bigeminy and ectopics post MI. Do I need a device?

Answered by
Dr. Vivek Pillai
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jul 01, 2018

Hi doctor,

Post MI (after one year) ventricular bigeminy is diagnosed. I am describing my cardiac problem. Please give your valuable suggestion. My problem is exactly one year back which was MI. Treatment started after 20 minutes with Reteplase and other drugs. Next day at 9 AM, I underwent angiogram and noticed RCA 99 % block, kept stent. After six months, I developed ectopics around 20 per minute. The drugs were changed to Bisoprolol, Metoprolol, Sotalol but there was no use. The cardiologist advised for EP study. What next? Do I need a device? I am sending briefly about my cardiac MR study and Holter report.

Dr. Vivek Pillai



Welcome to icliniq.com.

I have gone through your reports (attachment removed to protect patient identity).

Most probably, these VPC (ventricular premature contraction) are due to the scar in the RV (right ventricle). As advised by the cardiologists, I would also advise an EP study (electrophysiology studies), which, if positive, that, induces a VT (ventricular tachycardia) which needs an ICD (implantable cardioverter-defibrillator) implantation.

The second option is ablation of these VPC's. It works better if you have a structurally normal heart, but you have LV (left ventricle) dysfunction.

Also, ablation is fine if you have recurrent ICD shocks. So summing up, I would advocate an ICD if VT is induced.

For more information consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist

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