My first experience of bigeminy ... more dangerous than individual skipped beats?

[gothic_beauty]

As seems to be the way with my heart, just when I begin to build confidence that it is in good shape, it does something that resurrects my paranoia. This time, that something is bigeminy.

It happened last night, near the end of a day when I had not done or eaten anything remotely out of the ordinary. In fact, it was a very typical day. Until I felt a skipped beat, then another, and then all of a sudden they were coming literally every other beat. Thump ... thumpthump thump ... thumpthump thump ... thumpthump thump ... etc. I don't know how long this went on. I think that it was less than a minute. Probably about thirty seconds. I had no other symptoms, except hot and palpable fear.

For years I have endured countless combinations of PACs and PVCs, but never like this. I repeat: I'm really scared. Could this be indicative of a deeper problem, or of a gradual degeneration of my heart? I know that my heart is structurally sound, as I had an Echo done less than a month ago, and a Holter the month before that. I even had a blood test a couple of weeks ago. I don't know what more can be tested. On the other hand, I feel that I should do something, because bigeminy seems and feels so much scarier than skipped beats that occur one at a time. I know that there have been other posts about this condition, which is how I know what it is called, but I thought that I would write my own to see if anyone has any new information that has not before been shared. I also write, I admit, to vent about my reawakened fear of hear to my heart beat its last. I made it through the night and this morning, which is a good sign, but I'm still waiting to keel over. At least I was able to post this first!

[Sunnier]

I have had Supraventricular Tachycardia for many years.  At first it was scary but once I was diagnosed and did some reading about it, it became just an annoyance.  I am on 25 mg Atenelol 2x a day.  The last couple years, I have experienced episodes that are very different...palpitations that can last from 1 min to an hour.  Lately they have been happening every day.  My doctor had me wear a Holter Monitor (which I have done many times over the years) but this time my doctor said I have something that is very rare Bigeminy and Trigeminy.  Because I have had SVT for so many years, I am not easily scared by heart arrhythmia's so I would be the kind that would ignore it and just deal with it.  However, as I have been reading about it, I realize it is something that must be checked out because there can be underlying causes.  I will be going to my cardiologist for tests in a couple of weeks.  Arrhythmia here and there for a few seconds or a flutter now and then is no big deal but if it goes on and on and is frequently happening...get it checked!

[achillea]

As IsSomethingWrong says, the early extra beat in PVCs is. teeny little affair, because it occurs so very early that the ventricles do not get a chance to receive much blood.  They are thus not very full.

On the other hand, there is a natural pause that occurs before the next 'regularly scheduled' beat, and during that pause, the ventricles get a little extra time to become fuller than usual (the chambers are elastic),

The heart is under orders to pump out as much blood as it receives, so, sensing the slightly greater load, it gives a harder than usual contraction.

This is the giant 'THUMP' that many of us perceive and worry about.

Usually, it is just the heart doing its job.

[is_something_wrong]

You very rarely notice the extra beat in PVCs (the PVC itself). That's why it feels like the heart "skips" a beat.

With PACs, you often notice a "double" beat or a "weak" extra beat.

[wmac]

I thought ventricular bigemny would read like this from my understanding
xXxXxXxX its every other beat pvc

[is_something_wrong]

You're welcome. Yes, completely benign :-)

[gothic_beauty]

Thank you everyone for your responses! Your knowledge and reassurance work wonders. They really do.

Thank you in particular to is_something_wrong for clearing up the nature of what happened! Next time I attempt to attach a label to the activity of my heart, I'll read the definition more closely. That being said, trigeminy hardly sounds less terrifying than bigeminy. Is it really benign??

wmac, I am sooooooo sorry for what you went through the other day. Knowing how horrifying my own 30-second episode was, I can hardly imagine what it must have been like to stick it out for an hour. My condolences and my sincere hopes for a normal heart rhythm in the future!

[wmac]

I had a bad episode of bigemny on monday. It lasted an hour finally decided to go to the er and of course when they got me hooked up it stopped. But an hour really ugh.. It was absoultly horrible!

[is_something_wrong]

What you described is not bigeminy.

Bigeminy is as follows:

Normal rhythm:
x----x----x----x----x

PAC bigeminy:
xx-----Xx------Xx------Xx------ (large X is the next normal beat after ectopic)

PVC bigeminy:
x--------X--------X--------X (you only notice that your heart rate slows to half with very heavy beats)

What you describe is PAC trigeminy, a completely benign phenomenon.

PAC bigeminy, if it happens extremely frequent, may be a sign of a bypass tract (extra pathway), causing retrograde conduction and triggering a new atrial beat after the normal one. This would usually be seen on EKG, and PAC bigeminy is usually a normal phenomenon. PVC bigeminy is normal and common for a brief duration, but if it happens extremely frequently (hours a day) it may be a sign of slowed conduction somewhere in the ventricle (like after a heart attack), but again, in general it's a normal phenomenon.

And completely irrelevant for you, because you don't have bigeminy :)

[CFS56]

I have had bigeminy a couple of times..just recently had a brief episode only lasting a few seconds.  I have had it last for a couple of hours though and even though it's really scary I am still here to talk about it.  I called my EP the second episode I had and he wasn't concerned. Told me it wasn't life theatening and wasn't anything to be overly concerned about.  But I can relate..it's a very unpleasant, scary, feeling.

[seaweib]

I'm not an expert by any means on bigeminy but from what I've been told, it is of course less desirable than single isolated ectopic beats but is not a dangerous rhythm.  I believe bigeminy is a concern only to the extent that it means increased PACs and PVCs which still is not a concern unless they get up to the tens of thousands.

I think the fact that it only lasted 30 seconds is comforting and anxiety probably was a contributor since you sound very heart conscious.  Also, when one becomes very heart conscious, you're mind can play tricks on you and sometimes you think you're having palps when you're actually not.  That happens to me anyways.