Bigeminy/Trigeminy: Hi all, I was... - Atrial Fibrillati...

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Bigeminy/Trigeminy

Keswickman profile image
46 Replies

Hi all,

I was wondering if anyone here is in constant bigeminy or trigeminy?

I have noticed over the last few days that I seem to be in a mixture of both and, unless is stops whilst I am asleep, it is pretty much constant. Checks on my Kardia confirm this.

Despite deep breathing exercises, nothing appears to be stopping it except when I’m out walking the dog so my heart rate obviously raises a bit.

Ive read and it’s confirmed somewhat by Dr Sanjay, that as long as my heart is ok and I’m not fainting or going lightheaded, then it is what it is and it’s not really a major problem. If it goes on for years though, then it may cause heart failure in the long term.

Does anyone else have experience of this?

Thanks

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Keswickman profile image
Keswickman
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46 Replies
ForensicFairy profile image
ForensicFairy

A high burden of PVCs can cause structural issues of the ventricle. If you’re in persistent and constant bigeminy and trigeminy, then your burden is between 30-50% and you should to see a doctor. That’s lot of pressure on the cardiac system and your heart if it’s all the time.

John3333333 profile image
John3333333

I have been experiencing episodes of bigeminy for a few years. My episodes used to last for days, but now I take 100mg of flecainide, which stops the episodes within 90 minutes. All my recorded episodes have been PAC bigeminy. I rarely get PVCs in any form.

Keswickman profile image
Keswickman in reply toJohn3333333

Thanks John. I am 6 months overdue my cardiologist appt which to be fair my GP has chased but nothing yet. Ive only got Bisoprolol as a PIP, which I’ve never had to use. No other meds for PAF as CHADs score is 0 and again, episodes of that are rare. It’s the ectopics that are getting worse, which will no doubt some point increase the AF.

MaryCa profile image
MaryCa in reply toKeswickman

Bisopropol is a rare control drug. It won't help with arythmias

Keswickman profile image
Keswickman in reply toMaryCa

Hi. Yes I was prescribed that a year ago when I saw my cardiologist for the first time. It was only for PAF should my heart rate rise too much. As I have bradycardia, I’ve shied away from using them as anybPAF episode has been very short in duration. At that point my ectopics were daily but only a few hundred or low 1000s so he wasnt concerned.

Thanks

Ilovedogs12 profile image
Ilovedogs12 in reply toKeswickman

I have constant bigeminy and trigeminy. For the last few months it's been controlled well by Diltiazem slow release but recently I have been having more and more episodes until it's now almost back to being constant.

I usually walk for around three quarters of an hour each day which didn't happen when we had compacted frozen snow on the ground, and I'm wondering if the lack of exercise has made it worse.

Usually it's just the pounding heartbeat that is noticeable but last week I was in bad form for a whole day with fatigue, sleeping all afternoon, a bit breathless, heavy arms, tight chest and the feeling of a restriction in my throat. I rested all day, and in the evening I had a slight pain in my chest which lasted a few minutes, followed by pins and needles in my right arm for a moment or so, and I started to feel better. By bedtime I felt fine, but I felt tired for a couple of days afterwards.

My cardiologist says we must get on top of the bigeminy/trigeminy because it could cause damage in the long run.

Keswickman profile image
Keswickman in reply toIlovedogs12

Sounds like me but I’m not on any medication and can’t get an appt to see the cardiologist. Even a gentle reminder from my GP hasn’t helped.

Not much I can do at the moment except try to chill out and not let it get me down.

Thanks for the reply and all the best.

Ilovedogs12 profile image
Ilovedogs12 in reply toKeswickman

To be honest I ignore it most of the time because I could get very anxious if I didn't, and that would make things worse. But when it makes me ill that's a different story.

I have a Kardia which I tend not to use from day to day, but I used it when I was ill last week and the readings were all over the shop so I sent them to my cardiologist with an account of how I felt at the time.

I also use it a few times at random before appointments with him so he can see an up to date record, and he says it's very useful.

In May last year he advised me to cut out as much caffeine as possible from my diet including chocolate 😕. I was very good but I fell off the chocolate wagon over Christmas, but I've not had any since new year. I am not overweight, never smoked, eat a healthy diet and have my walk every day if possible. He also said I should avoid stress which isn't always easy if it's beyond my control but I do quite well.

I think you may be waiting for your first cardiology appointment? I don't know if anything I've said will be useful to you but I hope it might help.

All the best ☺️.

Keswickman profile image
Keswickman in reply toIlovedogs12

Thank you.

I gave up caffeine and alcohol 2 years ago but not chocolate! Like you I keep myself pretty fit and walk 4 hours a day. The biggest problem I have is reaching for the Kardia. I find myself using it several times a day and get frustrated. I have a fairly stress free life but do get anxious over routine things.

I am convinced it’s this that’s causing the problems but can’t seem to get round it. I wake up thinking about things I need to do or have done that aren’t right etc, and they’re often not important things.

I do look at Dr Sanjay Gupta videos on YouTube and these help a lot.

Ilovedogs12 profile image
Ilovedogs12 in reply toKeswickman

I also get anxious about routine things, and wake up thinking about similar things to yourself and can spend hours lying awake going over and over them. My husband put Spotify on my phone and I have playlists of my favourite songs, not the typical relaxing sounds but just songs that I love, and I have Bluetooth headphones. I've found putting these on when I'm lying awake relaxes me. Mind you, I have to make sure I don't start tapping my foot because that drives him mad 🤣. And singing along is definitely banned!

Kimmieblue profile image
Kimmieblue in reply toIlovedogs12

Hilarious..... lying in bed and singing when listening to your music is definitely banned. Sorry, that had me in fits of laughter. :)

K.

Ilovedogs12 profile image
Ilovedogs12 in reply toKimmieblue

He has a lot to put up with 😂

OzJames profile image
OzJames in reply toKeswickman

Stop the constant looking at devices it does cause anxiety. I now only wear an Apple Watch set to notify me when AF hits. I am very Symptomatic anyway and I know before the watch! I started breathing properly through my nose and take magnesium and my ectopics are now only felt once or twice a month instead of a few days a week. Incorrect breathing does affect our bodies. Read James Nestor Breath, it’s an easy informative read..

MaryCa profile image
MaryCa in reply toKeswickman

You can eat white chocolate all you want, no caffeine in it.

Ilovedogs12 profile image
Ilovedogs12 in reply toMaryCa

My cardiologist hid that from me!😂

Thanks!

MaryCa profile image
MaryCa in reply toIlovedogs12

He wouldn't be too happy with the sugar in it though. Sugar drives inflammation, inflammation drives AFib. If we could all live a perfect life with no alcohol, no sugar, no caffeine, no processed foods we'd all be fabulous. But that's not easy to do

Ilovedogs12 profile image
Ilovedogs12 in reply toMaryCa

Well apart from liking a bit of chocolate now and again (but I am abstaining) I only have naturally occurring sugar. I'm not a fan of cakes, sweets, biscuits etc and the only processed food I eat is bread, unless we have a rare meal out. It's not a conscious choice, it's just the way I am. So I have a healthy diet. We grow our own veggies and I cook from scratch.Unfortunately there's no accounting for genes and that's my downfall 😕

MaryCa profile image
MaryCa in reply toIlovedogs12

Watch the ingredients on the bread you're eating, a lot of them have additives, even palm oil added. You'd be surprised what they put in some bread these days, I know I was when my sister got me to read the pack last Christmas. A lot of the part baked bread rolls in supermarkets are literally flour, yeast, salt, water with no additives. Definitely worth exploring. I love home grown veg. Nothing like them.

Ilovedogs12 profile image
Ilovedogs12 in reply toMaryCa

I already read the ingredients on the bread wrapper and most of them wouldn't make it into my basket.

I'm the most boring person really 😂, I like to know exactly what I'm eating.

MaryCa profile image
MaryCa in reply toIlovedogs12

Love it. A person who likes food to be food, as it's meant to be. If you're on Instagram, find Sophie Morris, she's fantastic at foods and what's in them and the great alternatives

bee2 profile image
bee2

I have Bigeminy wasn't aware Kardia highlighted them I usually get Unclassified

Ilovedogs12 profile image
Ilovedogs12 in reply tobee2

I have a six lead Kardia and it doesn't say 'bigeminy' or 'trigeminy', it says 'unclassified'. And the heart rate on the Kardia is usually very low when I'm in bigeminy/trigeminy.

If the pattern on the reading shows a big beat followed by a few humps (you will realise I don't know how to read it 🤣) my cardiologist says that's the bigeminy/trigeminy.When it's a nice neat tidy pattern I know it's normal.

bee2 profile image
bee2 in reply toIlovedogs12

I don't know how to read it either which makes me wonder why I bought it just to scare myself. Lol

Ilovedogs12 profile image
Ilovedogs12 in reply tobee2

My GP suggested I get it when I was waiting for my first cardiology appointment, and I kept using it every time I noticed anything which was nearly all the time. I hadn't a clue what I was looking at so I got my husband to use it to have a comparison. His was very neat and tidy, mine looked like a toddler had been let loose with a felt pen, and that was scary!So I put it away until I saw the cardiologist and now I only use it to show him the readings.

Keswickman profile image
Keswickman in reply toIlovedogs12

This is what mine looks like when it’s ’having a go’!!

Heart beat
Ilovedogs12 profile image
Ilovedogs12 in reply toKeswickman

How did you attach that?

Keswickman profile image
Keswickman in reply toIlovedogs12

Just screenshot it and saved it to photos on my phone.

Ilovedogs12 profile image
Ilovedogs12 in reply toKeswickman

This is mine now and I can't feel anything.

ECG
Keswickman profile image
Keswickman in reply toIlovedogs12

Blimey. Great if you can’t feel it. I seem to feel everything.

Ilovedogs12 profile image
Ilovedogs12 in reply toKeswickman

I can feel it a lot of the time but not always. At the moment I can't feel my heartbeat but I have the constricted feeling in my throat. It's like I've swallowed something that has got stuck.

Sometimes my heart feels like I have Animal from the Muppets wildly bashing his drums in my chest.

Keswickman profile image
Keswickman in reply tobee2

That’s the reading I normally get. There is always a p wave and it says no AF. It’s just so jumpy in the chest.

Ilovedogs12 profile image
Ilovedogs12 in reply toKeswickman

Mine has never said 'no PF', I didn't know it said that. A couple of times it's said 'possible AF' and I have sent those to my cardiologist but he said it wasn't.

I just think it's not a good idea to try to interpret them when I don't know what I'm doing. But it sounds like you have some idea of what you are looking at when you can identify the p wave, so you might find it more beneficial.

bee2 profile image
bee2

I have Bradycardia so my heart rate drops lower my readings are either Bradycardia or Unclassified a few times I get possible AF

Ilovedogs12 profile image
Ilovedogs12 in reply tobee2

That's what mine say too.The cardiologist said it's a false bradycardia reading because the Kardia doesn't recognise the smaller beats so they're not all counted.

That's another reason I don't use it. It seems pretty pointless unless you can read the actual traces.

bee2 profile image
bee2

Mine were first spotted by paramedics I have had Bradycardia for several years and have had 6 heart attacks. but the last one was the first time Bigeminy was mentioned. I have had some crazy ECG's in hospital but that is usually when they give me meds I shouldn't get.

Ilovedogs12 profile image
Ilovedogs12 in reply tobee2

Mine was spotted by paramedics too. I haven't had any heart problems until last year when I had covid.

bee2 profile image
bee2 in reply toIlovedogs12

Has your heart been OK other than the strange beats?

Ilovedogs12 profile image
Ilovedogs12 in reply tobee2

So far. All scans etc show no damage.

bee2 profile image
bee2

That's good, just try to ignore the beats unless you have other symptoms 🤞🤞

Ilovedogs12 profile image
Ilovedogs12 in reply tobee2

Thanks. That's what I do. It's only when I feel ill with it like I did last week that I get concerned.

Palpman profile image
Palpman

Mine is textbook Bigeminy.

Bigeminy
WildIris profile image
WildIris

I would get that for hours at a time, then I had an aortic valve replacement. After that, I had a lot fewer ectopics, but got occasional afib. A few months later, I found out my kidneys were failing and it was too many chronic health problems. I gave up all sweeteners, lost my craving for sweets, and am now on a strict vegan diet, and feeling quite healthy, even my kidneys are better. In the last few years, I only got aFib for a few days when I took prednisone for a severe allergic reaction to a drug, otherwise no afib and very few ectopics since my delicious (because I really enjoy food now) diet change and weight loss.

Ilovedogs12 profile image
Ilovedogs12 in reply toWildIris

That's great that you are turning things around especially improving your kidneys, well done! I think diet has an important role in our overall health.

Ppiman profile image
Ppiman

I have this great deal with my home ECG calling it PVC bigeminy or similar. I am not sure it's not a kind of "micro-AF" that stops after 2-3 or more beats, originating on the atrium, rather than in the ventricles. That is my cardiologist's view, too. When I look at the ECG indeed, the "PVC" runs look exactly similar to those when I am having AF, just a joined up version.

If I were you, I would email my consultant with an ECG strip and ask his or her view.

Steve

Palpman profile image
Palpman in reply toPpiman

If it originates in the ventricles then it is PVC. If from the atrials then it is PAC.

Ppiman profile image
Ppiman in reply toPalpman

That's right - if only it were that clear to the AI algorithms that all home ECG devices use to make their "diagnoses". It seems they can become confused over what is what and mislabel runs of PACs as PVCs.

Steve

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