User:Mr. Ibrahem/Bigeminy

Bigeminy is a heart arrhythmia in which, following each regular heartbeat, there is a single ectopic beat (irregular heartbeat). There are three types ventricular, junctional, and atrial. Generally there are no significant symptoms; though, there may be feelings of a skipped beat. Rarely, low blood pressure and lightheadedness may occur.

Causes include stimulants (psychological stress, caffeine, cocaine); alcohol; high thyroid; low oxygen (coronary artery disease, pulmonary embolism, drowning); low potassium; digoxin toxicity; mitral valve prolapse; and myocarditis. Diagnosis is by 12-lead electrocardiogram (ECG). In ventricular bigeminy, each sinus beat is followed by a premature ventricular contraction (PVC), than a pause, another normal beat, and then another PVC. In atrial and junctional bigeminy, the second beat is a premature atrial contraction (PAC) or premature junctional contraction respectively.

Outcomes are similar to that of PVCs. If there are more than six PVCs per minute, which is the case in bigeminy, investigations should be performed looking for an underlying cause. Those without symptoms do not generally require specific treatment; otherwise, beta-blockers, calcium channel blockers, or catheter ablation may be carried out. Outcomes are generally good; though, occasionally ventricular tachycardia can occur. Bigeminy is relatively common.