Related Experiment Videos
Termination of ventricular bigeminy by conversion to concealed forms
Insights
Overt ventricular bigeminy frequently converts to a concealed form, often indicated by specific patterns in sinus beats. This study highlights concealment as a common termination mode for ventricular bigeminy.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Arrhythmias
Background:
- Ventricular bigeminy presents as either overt or concealed.
- Understanding the transition between these forms is crucial for arrhythmia management.
Purpose of the Study:
- To investigate the frequency of overt ventricular bigeminy converting to the concealed form.
- To identify patterns associated with this conversion.
Main Methods:
- Analysis of ambulatory electrocardiographic recordings from 25 patients.
- Examination of over 40 episodes of monomorphic ventricular bigeminy per patient.
- Statistical analysis (binomial distribution) of sinus beats between bigeminal events.
Main Results:
- A statistically significant predominance of odd or even sinus beats indicated conversion in 14 of 25 patients.
- Progressive prolongation of the coupling interval preceded termination in 74 episodes across 9 patients.
- Concealment is a prevalent mode of bigeminy termination.
Conclusions:
- Ventricular bigeminy frequently terminates via concealed mechanisms.
- Observed patterns suggest progressive conduction delay at the arrhythmogenic focus in some cases.
Abstract:
Ventricular bigeminy may be either overt or concealed. In this study, we attempted to determine the frequency with which the overt form converted to the concealed variety. Ambulatory electrocardiographic recordings from 25 patients with greater than 40 episodes of monomorphic ventricular bigeminy were examined. A statistically significant (P less than 0.01, binomial distribution) predominance of odd or even number of sinus beats between the end of a bigeminal episode and the next ventricular premature beat was considered to be evidence for conversion of overt to concealed bigeminy. In 14 of the 25 cases, the number of episodes of bigeminy followed by odd numbers of sinus beats was beyond these statistical bounds. In 74 episodes in 9 patients, progressive prolongation of the coupling interval during bigeminy occurred before termination. These data demonstrate the high prevalence of concealment as a mode of termination of bigeminy. In a small number of episodes, this occurs in a pattern suggestive of progressive delay of conduction in or around an arrhythmogenic locus.