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Atrial Bigeminy in a Patient with Normal AV Nodal Conduction

Image 1 of 2 in Series "Atrial Bigeminy Occurring with Normal and Abnormal AV Conduction"

Description

The rhythm is sinus rhythm with frequent premature atrial complexes (PACs) in a bigeminal pattern. The patient’s heart rate is approximately 75/min. The interval between the sinus P waves and the PACs varies from 625-682 msec. Normal AV nodal conduction is inferred from the conduction of all PACs to the ventricles with no significant prolongation of the interval between each PAC and the following QRS complex.

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This image is part of the series "Atrial Bigeminy Occurring with Normal and Abnormal AV Conduction"

Other images in this series

Atrial Bigeminy in a Patient with Abnormal AV Nodal Conduction

by: Joe B. Calkins. Jr., M.D.

The rhythm is sinus rhythm with frequent premature atrial complexes (PACs) in a bigeminal pattern. None of the PACs are conducted to the ventricles, which results in a heart rate of approximately 40/min. The interval between the sinus P waves and the PACs is consistently 688 msec. The patient’s abnormal AV node is unable to conduct at such short intervals, but is able to conduct all sinus P waves following the longer interval between the PACs and the subsequent sinus P waves. An additional manifestation of conduction system disease is the presence of left bundle branch block.