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Atrial bigeminy

MedGen UID:
537419
•Concept ID:
C0262382
•
Disease or Syndrome
Synonyms: Atrial Bigeminy; Atrial Bigeminy by ECG Finding; Atrial Bigeminy by EKG Finding
SNOMED CT: Atrial bigeminy (251173003)

Definition

An electrocardiographic finding of a sinus beat followed by a premature atrial complexes for three or more consecutive cycles; a regularly irregular rhythm of normal and abnormal P waves in a 1-1 ratio. (CDISC) [from NCI]

Professional guidelines

PubMed

Fetal brady- and tachyarrhythmias: new and accepted diagnostic and treatment methods.
Jaeggi ET, Nii M
Semin Fetal Neonatal Med 2005 Dec;10(6):504-14. Epub 2005 Oct 4 doi: 10.1016/j.siny.2005.08.003. PMID: 16213203
The differential diagnosis of bigeminal rhythms.
Wing JP, Phibbs B
Heart Lung 1977 Nov-Dec;6(6):995-1004. PMID: 244329

Recent clinical studies

Etiology

Consequences of chronic frequent premature atrial contractions: Association with cardiac arrhythmias and cardiac structural changes.
Gunda S, Akyeampong D, Gomez-Arroyo J, Jovin DG, Kowlgi NG, Kaszala K, Tan AY, Koneru JN, Kron J, Ellenbogen KA, Huizar JF
J Cardiovasc Electrophysiol 2019 Oct;30(10):1952-1959. Epub 2019 Aug 1 doi: 10.1111/jce.14067. PMID: 31310360Free PMC Article
Frequent Atrial Premature Complexes and Their Association With Risk of Atrial Fibrillation.
Acharya T, Tringali S, Bhullar M, Nalbandyan M, Ilineni VK, Carbajal E, Deedwania P
Am J Cardiol 2015 Dec 15;116(12):1852-7. Epub 2015 Oct 3 doi: 10.1016/j.amjcard.2015.09.025. PMID: 26611122
Doppler echocardiographic isovolumetric time intervals in diagnosis of fetal blocked atrial bigeminy and 2:1 atrioventricular block.
Sonesson SE, Eliasson H, Conner P, Wahren-Herlenius M
Ultrasound Obstet Gynecol 2014 Aug;44(2):171-5. Epub 2014 Jun 27 doi: 10.1002/uog.13344. PMID: 24585694
Magnetophysiologic and echocardiographic comparison of blocked atrial bigeminy and 2:1 atrioventricular block in the fetus.
Wiggins DL, Strasburger JF, Gotteiner NL, Cuneo B, Wakai RT
Heart Rhythm 2013 Aug;10(8):1192-8. Epub 2013 Apr 22 doi: 10.1016/j.hrthm.2013.04.020. PMID: 23619035Free PMC Article
Mechanisms in fetal bradyarrhythmia: 65 cases in a single center analyzed by Doppler flow echocardiographic techniques.
Eliasson H, Wahren-Herlenius M, Sonesson SE
Ultrasound Obstet Gynecol 2011 Feb;37(2):172-8. doi: 10.1002/uog.8866. PMID: 21264981

Diagnosis

Sinus Bradycardia With Nonconducted Atrial Bigeminy.
Templeton M, Carlberg DJ, Tabas JA, Mattu A, Brady WJ, Davis JE
Ann Emerg Med 2023 Oct;82(4):478-481. doi: 10.1016/j.annemergmed.2023.07.022. PMID: 37739750
Poincaré Plot Image and Rhythm-Specific Atlas for Atrial Bigeminy and Atrial Fibrillation Detection.
Garcia-Isla G, Corino V, Mainardi L
IEEE J Biomed Health Inform 2021 Apr;25(4):1093-1100. Epub 2021 Apr 6 doi: 10.1109/JBHI.2020.3012339. PMID: 32750972
Fetal and Neonatal Arrhythmias.
Jaeggi E, Öhman A
Clin Perinatol 2016 Mar;43(1):99-112. doi: 10.1016/j.clp.2015.11.007. PMID: 26876124
Diagnosing foetal atrioventricular heart blocks.
Sonesson SE
Scand J Immunol 2010 Sep;72(3):205-12. doi: 10.1111/j.1365-3083.2010.02434.x. PMID: 20696017
Fetal brady- and tachyarrhythmias: new and accepted diagnostic and treatment methods.
Jaeggi ET, Nii M
Semin Fetal Neonatal Med 2005 Dec;10(6):504-14. Epub 2005 Oct 4 doi: 10.1016/j.siny.2005.08.003. PMID: 16213203

Therapy

Tolerability and Safety of Lacosamide in Neonatal Population.
Bamgbose O, Boyle F, Kean AC, Stefanescu BM, Wing S
J Child Neurol 2023 Mar;38(3-4):137-141. Epub 2023 Mar 27 doi: 10.1177/08830738231164835. PMID: 36972493
Fetal and Neonatal Arrhythmias.
Jaeggi E, Öhman A
Clin Perinatol 2016 Mar;43(1):99-112. doi: 10.1016/j.clp.2015.11.007. PMID: 26876124
Blocked atrial bigeminy presenting with bradycardia.
Akdeniz C, Tanidir IC, Tuzcu V
Congenit Heart Dis 2012 Sep-Oct;7(5):E82-4. Epub 2012 Apr 2 doi: 10.1111/j.1747-0803.2012.00646.x. PMID: 22469245
Prediction of paroxysmal atrial fibrillation by analysis of atrial premature complexes.
Thong T, McNames J, Aboy M, Goldstein B
IEEE Trans Biomed Eng 2004 Apr;51(4):561-9. doi: 10.1109/TBME.2003.821030. PMID: 15072210
Atrial bigeminy with block associated with bradycardia and paroxysmal atrial fibrillation -- an important variant of the tachycardia-bradycardia syndrome.
Washington HG, Ward DE, Camm AJ, Spurrell RA
Clin Cardiol 1979 Apr;2(2):126-30. doi: 10.1002/clc.4960020207. PMID: 95576

Prognosis

Consequences of chronic frequent premature atrial contractions: Association with cardiac arrhythmias and cardiac structural changes.
Gunda S, Akyeampong D, Gomez-Arroyo J, Jovin DG, Kowlgi NG, Kaszala K, Tan AY, Koneru JN, Kron J, Ellenbogen KA, Huizar JF
J Cardiovasc Electrophysiol 2019 Oct;30(10):1952-1959. Epub 2019 Aug 1 doi: 10.1111/jce.14067. PMID: 31310360Free PMC Article
Frequent Atrial Premature Complexes and Their Association With Risk of Atrial Fibrillation.
Acharya T, Tringali S, Bhullar M, Nalbandyan M, Ilineni VK, Carbajal E, Deedwania P
Am J Cardiol 2015 Dec 15;116(12):1852-7. Epub 2015 Oct 3 doi: 10.1016/j.amjcard.2015.09.025. PMID: 26611122
Doppler echocardiographic isovolumetric time intervals in diagnosis of fetal blocked atrial bigeminy and 2:1 atrioventricular block.
Sonesson SE, Eliasson H, Conner P, Wahren-Herlenius M
Ultrasound Obstet Gynecol 2014 Aug;44(2):171-5. Epub 2014 Jun 27 doi: 10.1002/uog.13344. PMID: 24585694
Magnetophysiologic and echocardiographic comparison of blocked atrial bigeminy and 2:1 atrioventricular block in the fetus.
Wiggins DL, Strasburger JF, Gotteiner NL, Cuneo B, Wakai RT
Heart Rhythm 2013 Aug;10(8):1192-8. Epub 2013 Apr 22 doi: 10.1016/j.hrthm.2013.04.020. PMID: 23619035Free PMC Article
Diagnosing foetal atrioventricular heart blocks.
Sonesson SE
Scand J Immunol 2010 Sep;72(3):205-12. doi: 10.1111/j.1365-3083.2010.02434.x. PMID: 20696017

Clinical prediction guides

Partial and complete loss of myosin binding protein H-like cause cardiac conduction defects.
Barefield DY, Yamakawa S, Tahtah I, Sell JJ, Broman M, Laforest B, Harris S, Alvarez-Arce A, Araujo KN, Puckelwartz MJ, Wasserstrom JA, Fishman GI, McNally EM
J Mol Cell Cardiol 2022 Aug;169:28-40. Epub 2022 May 6 doi: 10.1016/j.yjmcc.2022.04.012. PMID: 35533732Free PMC Article
Frequent Atrial Premature Complexes and Their Association With Risk of Atrial Fibrillation.
Acharya T, Tringali S, Bhullar M, Nalbandyan M, Ilineni VK, Carbajal E, Deedwania P
Am J Cardiol 2015 Dec 15;116(12):1852-7. Epub 2015 Oct 3 doi: 10.1016/j.amjcard.2015.09.025. PMID: 26611122
Doppler echocardiographic isovolumetric time intervals in diagnosis of fetal blocked atrial bigeminy and 2:1 atrioventricular block.
Sonesson SE, Eliasson H, Conner P, Wahren-Herlenius M
Ultrasound Obstet Gynecol 2014 Aug;44(2):171-5. Epub 2014 Jun 27 doi: 10.1002/uog.13344. PMID: 24585694
Diagnosing foetal atrioventricular heart blocks.
Sonesson SE
Scand J Immunol 2010 Sep;72(3):205-12. doi: 10.1111/j.1365-3083.2010.02434.x. PMID: 20696017
Prediction of paroxysmal atrial fibrillation by analysis of atrial premature complexes.
Thong T, McNames J, Aboy M, Goldstein B
IEEE Trans Biomed Eng 2004 Apr;51(4):561-9. doi: 10.1109/TBME.2003.821030. PMID: 15072210

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