bigeminy - is this what I had?

[ca39]

I posted a question to the doctor.  I have a history of PVCs.  The other night I noticed my heart beats were "off" and I checked my pulse.  It was 38 bpm.  Freaked me out!  My pulse felt regular, but slow.  beat, long pause, beat, long pause, beat.  The doctor thinks it was bigeminy.  I thought bigeminy was beat, pause BEAT, beat, pause BEAT, beat.  
And can someone tell me what a couplet feels like?  If you have a bunch of pvcs in a row, I read your heart rate is really fast, but don't you feel the pauses and hard thump that comes with a single pvc?

[Brooke_38]

Bigeminy is a type of heart arrhythmia in which abnormal heart beats occur every other concurrent beat. A typical example is with bigeminal premature ventricular beats, also known as a premature ventricular contractions/complexes (PVC). Following the PVC there is a pause and then the normal beat returns - only to be followed by another PVC. The continuation of this pairing of beats is an example of bigeminy.

These  can increase depending on the number of beats involved in the abnormal system. If every other beat is abnormal, you can describe it as bigeminal. If every third beat is aberrant, it is trigeminal; every fourth would be quadrigeminal. Typically, if every fifth or more beat is abnormal, the aberrant beat would be termed occasional.

Bigeminy is contrasted with couplets, which are paired abnormal beats. If these concurrent beats number three, they are called triplets and are considered as a brief run of non-sustained Ventricular tachycardia or NS-VT.


Examples:
Bigeminal premature ventricular contractions = Normal, PVC, Normal, PVC...
Trigeminal premature atrial contractions = Normal, Normal, PAC, Normal, Normal, PAC...
Bigeminal Couplets: Normal, Normal, PVC, PVC, Normal, Normal, PVC, PVC...
NS-VT: Normal, Normal, PVC, PVC, PVC, PVC, Normal, Normal, PVC....ect

I hope this helps you and doesn't confuse you :)

[julesluvsdrew]

Hey there,do you normally have that low of a pulse??Are you an athlete?

[Momto3]

Bigeminy can lead to a false pulse reading.  I used to think my pulse was in the 30's and 40's, but because of the arrythmia, the doctor explained I was not getting accurate readings.  He calculated it to be 78, when I thought it was 40ish.

[ca39]

Thanks for the response.  When you say a bigeminal premature ventricular contractions = Normal, PVC, Normal, PVC, what does a PVC feel like...just a pause?

My normal pulse is in the 60's.  I notice when I have occasional pvcs, it lowers in the 50's sometimes, but I have never noticed my pulse in the 30's before.

[Brooke_38]

It's all about timing of the PVC. You may experience the feeling of a pause or you may feel what is referred to asCannon A waves. This could be observed in the jugular venous pulse if the timing of the PVC causes an atrial contraction against a closed tricuspid valve.

Ditto to what Momto3 said about the pulse deficit. If the PVC is felt as a pause, you are not counting it as a beat when you really should

[rampanand]

I hope your are feeling better today. Could you comment on clinical significance of complex PVC? Would ignoring bigeminies lead to ventricular tachycardia?  Thanks

[Brooke_38]

Complex ventricular ectopy can be defined as PVCs that:

Occur in pairs, triplets or more prolonged runs of ventricular tachycardia.
Fall in the vulnerable period of the cardiac cycle
(R on T).
Have more than one morphology.
A close correlation exists between the complexity of PVCs and the risk of developing ventricular tachycardia and fibrillation in patients with cardiac disease. People who have complex ventricular ectopy without apparent cardiac disease only RARELY experience life-threatening ventricular arrhythmias.

I want to reiterate that people who have structurally normal hearts are rarely at risk of developing life threatening VT from bigeminal PVC's. I lived through  VT at 250 bpm. I just went through an ablation last Fri for RVOT-VT (Right Ventricular Outflow Tract VT)

I hope this answers your question. And thanks for asking or hoping that I'm better today.