Causes of Ventricular Bigeminy

Introduction

Ventricular bigeminy is a type of heart rhythm disturbance classified as a ventricular arrhythmia. It occurs when each normal heartbeat (sinus beat) is followed by a premature ventricular contraction (PVC). This produces a pattern where every second beat is abnormal.

Causes of Ventricular Bigeminy

Ventricular bigeminy can occur due to various reasons, ranging from benign to life-threatening conditions. Below are the major causes:

1. Electrolyte Imbalances

  • Low potassium (hypokalemia)
  • Low magnesium (hypomagnesemia)
  • High calcium (hypercalcemia)

2. Myocardial Ischemia or Infarction

  • Coronary artery disease
  • Myocardial infarction (heart attack)
  • Reduced oxygen supply to the heart

3. Structural Heart Disease

  • Cardiomyopathy (dilated, hypertrophic, restrictive)
  • Valvular heart disease
  • Congenital heart defects

4. Drug and Toxin Exposure

  • Stimulants like caffeine, nicotine, or alcohol
  • Certain medications (e.g., digoxin toxicity, beta-agonists, antiarrhythmic drugs)
  • Recreational drugs (cocaine, amphetamines)

5. Increased Sympathetic Activity or Stress

  • Anxiety, panic attacks
  • Hyperthyroidism (excess thyroid hormone)
  • Excessive physical exertion

6. Heart Conduction System Disorders

  • Sick sinus syndrome
  • Ventricular pre-excitation syndromes (e.g., WPW syndrome)

When to Seek Medical Attention?

Ventricular bigeminy can be benign, but certain symptoms require urgent evaluation: - Dizziness or fainting (syncope) - Chest pain - Shortness of breath - Palpitations with fatigue

If these symptoms occur, consulting a cardiologist is recommended for further evaluation and necessary tests such as an ECG, Holter monitoring, or echocardiogram.

Conclusion

Ventricular bigeminy may result from harmless factors like stress or occur due to underlying serious conditions such as heart disease or electrolyte imbalances. Identifying and treating the root cause is essential for managing this rhythm disturbance effectively.

Source recommendations

1. American Heart Association Guidelines on Arrhythmias

  1. https://www.heart.org/en/health-topics/arrhythmia
  2. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
  3. https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia
  4. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
  5. https://pubmed.ncbi.nlm.nih.gov/29084733/

2. European Society of Cardiology Guidelines on Ventricular Arrhythmias

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
  2. https://academic.oup.com/eurheartj/article/43/40/3997/6675633
  3. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
  4. https://pubmed.ncbi.nlm.nih.gov/36017572/
  5. https://www.sciencedirect.com/science/article/pii/S2405500X22010945

Our advantages:

patient2376100
Best practices from USA, EU and Japan
Our answers to your questions are based on the clinical recommendations of countries with the most developed healthcare systems in the field of cardiology in the USA, the EU and Japan.
prescription18648039
Always up-to-date information
On a daily basis, we monitor for you all new scientific research publications in leading scientific journals on medical issues of interest to you.
We monitor all innovations and changes in the field of cardiac disease treatment on a daily basis.
fvfflf7q
Get second opinion
Here you can learn everything that even your doctor may not know about cardiology (if he does not speak English and he does not read 117 leading medical journals on cardiology every month).
1xr4duup
The most comprehensive and up-to-date collection of free cardiology materials
Our website contains the most comprehensive and up-to-date collection of free cardiology materials in your country.
Every 3-5 years, half of the scientific approaches to treatment in the field of cardiology are reviewed as a result of specialized scientific discoveries. With us, you don't have to wait these years to learn about the best ways to treat you and your loved ones.
arrow
Please register in order to receive information regarding possible complications and new approaches to treatment of cardiovascular diseases via email in our Newsletters.
arrow