
Key Takeaways
Atrial bigeminy is a sinus rhythm that occurs when every other beat is a premature atrial contraction (PAC). Bigeminy is the alternation between a regular heartbeat and an extra, skipped heartbeat. People may experience heart palpitations or fluttering. They may describe the sensation as the heart skipping a beat. Many people will experience atrial bigeminy at some point in their lives, and it is not usually a cause for concern.
How to Spot Atrial Bigeminy on Your Watch ECG
The main feature of atrial bigeminy is that PAC is coming after every normal PQRST complex. The rhythm is irregular since there’s a compensatory pause every after ectopic beats, and the P-waves are present but abnormal in PAC. Also, QRS and PR intervals are normal in measurement.



What Are Common Symptoms of Atrial Bigeminy?
Atrial bigeminy, as a manifestation of PACs, is a harmless rhythm in the proper clinical context. Most people with PACs do not have organic heart disease, although PACs are more common in patients with heart disease than in those without. Caffeine intake, fatigue, smoking, alcohol use, and emotional stress, as these factors have been linked to the occurrence of PACs.
Any Cause for Concern?
Atrial bigeminy is not usually a cause for concern. However, a person should seek prompt medical attention if any of the following symptoms accompany their palpitations:
- lightheadedness or dizziness
- feeling faint
- passing out
As always, if you show signs of a potential atrial bigeminy, contact your healthcare provider as soon as possible to rule out the presence of harmful underlying conditions.
Still Not Sure How to Spot Atrial Bigeminy on Your Watch ECG?
Your smartwatch can also be your partner in looking after your heart. If you’re concerned about atrial bigeminy, get your smartwatch ECGs analyzed by experts within minutes on the QALY app: iOS and Android.
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