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ECG: Ventricular Premature Beats

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Stanley Medical College, Department of Medicine

1. The ECG shows a 45-year-old diabetic man with episodes of palpitations who presents with ventricular trigeminy. 2. Ventricular trigeminy is characterized by ventricular premature beats occurring after every two normal sinus beats with a compensatory pause. 3. Further investigation with Holter monitoring is recommended to better characterize the ventricular arrhythmia and assess for underlying cardiac disease.

Health & Medicine
1 of 21
Prof .Dr.K.H.NOORUL AMEEN’S unit M6 Dr.G ARUN KUMAR ECG OF THE WEEK
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[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IMP: VENTRICULAR PREMATURE BEAT WITH COMPLETE COMPENSATORY PAUSE (VENTRICULAR TRIGEMINY) PROBABLY OF LEFT VENTRICULAR ORIGIN NORMAL RR INTERVAL 720 ms 2 TIMES RR INTERVAL ( pre ectopic + post ectopic interval = 2 sinus interval ) 1440ms COMPENSATORY PAUSE
VENTRICULAR PREMATURE BEAT ,[object Object],[object Object],[object Object]
RELATION TO SINUS P WAVE ,[object Object],[object Object],[object Object],[object Object],[object Object]
FREQUENCY ,[object Object],[object Object],[object Object],[object Object]
VENTRICULAR BIGEMINY
COUPLET
MORPHOLOGY ,[object Object],[object Object],[object Object],COUPLING INTERVAL ,[object Object]
INTERPOLATED VENTRICULAR EXTRASYSTOLE ,[object Object],[object Object],[object Object],[object Object],[object Object]
UNIFORM AND MULTIFORM VPB ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
R ON T PHENOMENON ,[object Object],[object Object]
CAUSES OF VPB ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GRADING
CLINICAL FEATURES ,[object Object],[object Object],TREATMENT USE OF ANTIARRHYTHMICS IN ISOLATED VPBs AND SHORT RUN VT HAVE NOT SHOWN ANY IMPROVED SURVIVAL USE OF BETA BLOCKERS HAS BEEN HELPFUL IN ABOLISHING VPBs IN PATIENT WITH STEMI AND IN PREVENTION OF VF AT PRESENT PHARMACOTHERAPY IS RESERVED ONLY FOR PATIENT WITH SUSTAINED VENTRICULAR ARRHYTHMIAS USE OF PROPHYLACTIC ANTI ARRHYTHMICS IS CONTRAINDICATED IN THE ABSENCE OF CLINICALLY IMPORTANT VT
THANK YOU REF : SHAMROTH GOLDBERGER HARRISON

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