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Premature Ventricular Contractions

normal
Lead II
25 mm/s10 mm/mV
Heart rate
72bpm
RR
833ms
QT
358ms
Type

Ventricular Trigeminy

A repeating pattern where every third beat is a PVC. Two normal sinus beats are followed by one PVC, then the cycle repeats. Lower ectopic burden than bigeminy.

Mechanism

A repeating pattern where every third beat is a PVC. Two normal sinus beats are followed by one PVC, then the cycle repeats. Lower ectopic burden than bigeminy.

Findings· 2
  • Repeating groups of three: two normal sinus beats followed by one PVC (wide QRS, no P wave, discordant T).
  • The pattern is highly regular with a fixed coupling interval.
Clinical Impact

Suggests an irritable ventricular focus. Less hemodynamically significant than bigeminy due to more normally conducted beats. Same workup as isolated PVCs if symptomatic or frequent.

Differential· 2
PAC with Aberrancy

Premature beat with wide QRS from rate-dependent BBB. Look for preceding abnormal P wave.

Ventricular Tachycardia

Three or more consecutive PVCs = VT by definition. Same wide QRS morphology.