Bigeminal Rhythm in a Woman With Palpitations, Dyspnea, and Fatigue.


A 58-year-old obese woman complained of palpitations, dyspnea, and fatigue. An electrocardiogram showed sinus bradycardia at a rate of 35 beats/min, a minimally irregular junctional escape rhythm at a rate of 49 beats/min, and, initially, escapeecapture bigeminy (Figure 1). The capture complexes have aberrant ventricular conduction, the result of a long R-R interval followed by a short one, the Ashman phenomenon. The R-P intervals shorten almost imperceptibly, and the following P-R intervals lengthen minimally. That and minimal slowing of the junctional rhythm result in the last P wave occurring only 0.08 seconds after the next to the last junctional escape complex, and the P wave is not conducted to the ventricles. It, however, does

DOI: 10.1016/j.amjcard.2015.07.075

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@article{Atluri2015BigeminalRI, title={Bigeminal Rhythm in a Woman With Palpitations, Dyspnea, and Fatigue.}, author={Prashanthi Atluri and David Luke Glancy}, journal={The American journal of cardiology}, year={2015}, volume={116 9}, pages={1483-4} }