bigeminy - is a certain form of arrhythmia characterized by premature excitation of the heart (extrasystoles) that appear after each normal heart beat. Thus, alternate cycles extrasystolic sinus and in a ratio of 1: 1.It is noted equal interval clutches.As a rule, such arrhythmia as bigeminy doctors mean ventricular or supraventricular (supraventricular) extrasystole.In this case, premature excitation of the heart is an extraordinary heart rate, which can be recorded on an electrocardiogram.
Extrasystoles healthy people make up almost 55 cuts per hour.In those moments when the beats normally characterized by alternating contractions with extraordinary cuts, especially if it is recorded on the electrocardiogram is very often, then it is considered a form bigeminy.
In addition, for this type of allodromy very difficult to determine its prognostic value of Holter monitoring without or during the day, as bigeminy for twenty-four hours can both appear and disappear.If this condition la
This form of arrhythmia characterized by regular alternation of single flowing normally complex with a ventricular arrhythmia, which is a kind allodromy.This marked a premature excitation from the right side of the heart, that is, from the ventricle.Supraventricular bigeminy is correct rhythmic alternating one heartbeat and one arrythmia.
digitalis intoxication is often manifested by symptoms such as ventricular bigeminy.In addition, there are frequent PVCs or at the time of the therapeutic treatment of digitalis overdose of these drugs or their sensitivity to toxic effects.
Ventricular bigeminy, especially in the form of group or politopnye extrasystoles indicates expression of the intoxication after the drug digitalis.As a rule, it would be dangerous to their transition to ventricular fibrillation.
Quite often, this type of arrhythmia occurs in patients with diseases of the SSSthe appointment of procainamide, Epinephrine, Novocain, quinidine.In addition, ventricular bigemini may occur after the application of certain types of anesthesia such as cyclopropane, chloroform and others. In some instances, this pathological condition develops as a consequence of treatment with electric pulses or by applying electrical stimulation of the heart.Also postkonversionny period often characterized by atrial and ventricular arrhythmia, paroxysmal VT et al., Which develop as a result of the damaging effect of current.
Causes of ventricular bigeminy may make severe poisoning by organophosphorus compounds occurring during the acute intoxication, as well as various violations of electrolyte balance in the myocardium, heart surgery, cardiac sensing cavities koronagrafiya other reasons.
symptomatic picture of ventricular bigeminy can proceed without feeling arrhythmia, although sometimes it is determined by the unevenness or intermittent pulse of the heart.It is noted the faint hearted push and punch followed by several more.In some cases, patients do not feel this bounce, and then it seems that the filling pulse is very weak, but in fact remain normal heart rate and amount of 60-80 beats per minute.As a rule, a state in the form of imaginary bradycardia, is not always possible to feel the pulse of the peripheral vessels.
The formation of this form of arrhythmia directly affected by the condition of the autonomic and central nervous system.
Underlying all causes bigeminy are changes in cardiac muscle of organic origin.It is also important to consider that even the most minor infractions in the myocardium during concomitant factors functional nature, especially with the effects of nerve extracardiac origin may be the cause of ectopic excitation center.
Moreover, against the background of the various forms of coronary heart disease can be a cause of bigeminy changes in the heart muscle or organic disorders of the heart when joining functional precipitating factors.For example, bigeminy observed in 80% of patients with a heart attack, with one of the most common disorders of the rhythm is ventricular bigeminy.And sometimes these beats lead to early to show signs of a lack of work coronary vessels.Often ventricular bigeminy provokes an attack of angina.Also, we have shown that frequently occurring forms of arrhythmia, especially after a heart attack, can become a cause of poor prognosis, becausesignificantly increases the risk of sudden death due to ventricular fibrillation.
bigeminy detected in patients in the presence of acquired rheumatic heart diseases, especially aortic stenosis and mitral valve prolapse.But the main cause of bigeminy organic genesis of the younger generation is the presence of rheumatic fever.
addition, bigeminy can be caused by myocarditis, infection and cardiomyopathy.Several less occurrence of this type of arrhythmia contributes to hyperthyroidism.
For bigeminy characterized by subjective symptoms such as feeling the impact in the field of heart, faults or heart stop for a short time.Is rarely given the pathological condition manifests itself or cardialgia stenokardialnymi pain, a sense of shock, a very strong compression and filling in the neck area.
Brain symptoms characterized by the appearance of the patient, a pathological condition bigeminy, bouts of dizziness, fainting, aphasia and whirling head.Among the rare form of the symptoms observed transient hemiparesis.
general signs of vegetative and neurotic character is appearing in a patient paleness, weakness, nausea, profuse sweating, anxiety, shortness of breath and some excited.
Typically, when a bigeminy and often appears premature excitation of the heart in patients with heart begins to beat short-lived, it seemed to be compressed, and the blows felt stupid character or flutter of the heart.But the appearance of pain in the heart is extremely rare.But if they arise, appear short pain pierces the property or undefined soreness, which is caused by irritation interoceptors a result of overcrowded at the time of ventricular pauses after early excitement of the heart and should be vigorously reduce it.In typical such feelings is also influenced by the sharp expansion of the processes of the atria due to the fact that at this moment all the chambers of the heart are reduced almost simultaneously.This pain in my heart very often resembles the pain of neurotic origin.
bigeminy sometimes causes a decrease in blood flow in the coronary vessels, particularly in coronary atherosclerosis, so it can be rather reminiscent of the typical symptoms of angina.In addition, while there is a push waves from the heart to the neck or head, which coincides with arrythmia.
bigeminy sometimes characterized by the appearance of dizziness and nausea as a result of reduced blood supply to the brain against the background of frequent extrasystoles.Typically, symptoms bigeminy considered an expression of the autonomic nervous system disorders.
ECG bigeminy is an alternation of cardio intervals and linked postekstrasisiolicheskogo nature, which are determined on rhythmogram alternating elongated and shortened intervals (RR).Bigeminy on scatterogram that continues throughout the recording period, revealed the two points together.A bigeminy episodes are characterized by another type of record.
Basically bigeminy needs no special treatment appointment.To start enough to eliminate triggers psychological and emotional origin, as well as chronic foci of infection.
But in order to make a decision in determining the tactics of drug therapy pay attention to the tolerance of the disease state, the number of premature excitation of the heart chambers during the day, the characteristic of premature beats, the presence of heart disease and other forms of arrhythmia, as bigeminy is not independentDisease.
Typically, after clarification of all causes bigeminy, proceed to the treatment of the underlying disease.As a result of arrhythmia neurogenic genesis prescribe sedatives or anti-anxiety agents, as well as consultation of the neurologist.When poisoning with medication, appearing bigeminy treated cancellation of these drugs.
the presence of cardiac disease may be administered antiarrhythmic drugs after individual inspection by a monitoring Holter.In this case, it can be assigned to drugs such as sotalol, Cordarone, lidocaine, procainamide, quinidine, diltiazem, and others.