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Bigeminy is contrasted with couplets, which are paired abnormal beats. Groups of three abnormal beats are called triplets and are considered a brief run of non-sustained ventricular tachycardia (NSVT), and if the grouping lasts for more than 30 seconds, it is ventricular tachycardia (VT).
Depending whether there are one, two, or three normal (sinus) beats between each PACs, the rhythm is called atrial bigeminy, trigeminy, or quadrigeminy. If three or more consecutive PACs occur in a row and at a frequency of 100 or more beats per minute, it may be called atrial tachycardia .
Arrhythmia may be classified by rate (tachycardia, bradycardia), mechanism (automaticity, re-entry, triggered) or duration (isolated premature beats; couplets; runs, that is 3 or more beats; non-sustained = less than 30 seconds or sustained = over 30 seconds). [citation needed] Arrhythmias are also classified by site of origin: [citation needed]
A premature ventricular contraction (PVC) is a common event where the heartbeat is initiated by Purkinje fibers in the ventricles rather than by the sinoatrial node.PVCs may cause no symptoms or may be perceived as a "skipped beat" or felt as palpitations in the chest.
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Doctors on the ground had become worried when they saw that Scott's and Irwin's EKG had developed a bigeminy rhythm. Caused by a lack of potassium , the ventricles beat in couplets, instead of a single constant beat.
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Ventricular escape beats occur when the rate of electrical discharge reaching the ventricles (normally initiated by the heart's sinoatrial node (SA node), transmitted to the atrioventricular node (AV node), and then further transmitted to the ventricles) falls below the base rate determined by the rate of Phase 4 spontaneous depolarisation of ventricular pacemaker cells. [1]