More VEBs in Quadrigeminy
Report:
Sinus rhythm
VEBs in couplets, quadrigeminy
Left atrial abnormality (LAA)
Probable LVH with STT changes
Lead V3 missing
Comment:
Each quadrigeminal grouping consists of two (Rosenbaum) VEBs and two sinus beats. The second VEB in each couplet appears to be retrogradely conducted, with some post-ectopic SA depression. It is somewhat questionable whether the term quadrigeminy is clinically useful, unlike bigeminy or trigeminy (Fig 137a below, in the same patient). Certainly pentageminy is de trop. Bigeminy itself is, by the way, pleonastic – two twins. It should be geminy!
The LVH voltage is seen in SV1 + RV6 > 36 mm or, even better, RV6 > RV5.
This patient had dilated cardiomyopathy (LV 7.7/6.0 cm) with fractional shortening 10% (normal > 29%). He is an example of Rosenbaum’s ‘normal’ pattern in an abnormal heart.
If you have any suggestions for or feedback on this report, please let us know.
Hi, can we chat about some terms and conditions?
The library and it's records are licensed under the Creative Commons Attribution 4.0 International license.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
By clicking agree below, you are agreeing to adhere to CC BY 4.0.